What behavioral interventions are safe and effective for treating obesity?

Hypnosis has been used as an adjunct to behavioral therapy for weight loss in multiple small studies. Two meta-analyses^9,10 concluded that behavioral therapy alone yielded an average weight loss of 6.05 kg; with the addition of hypnosis, the average weight loss rose to 14.88 kg.

Depression and binge-eating disorder commonly coexist with obesity. Obese patients seeking treatment have a lifetime prevalence of affective disorders over 30%. Depression is associated with higher dropout rates from treatment programs for obesity.¹¹ However, there are no rigorous studies that indicate that treatment of depression is necessary to achieve optimal weight loss.^12,13

Recommendations from others

The Centers for Disease Control and Prevention recommends behavior changes, including an increase in physical activity and in the intake of vegetables and fruits.¹ The American Academy of Family Physicians recommends working to improve self-efficacy—the patient’s belief that they can succeed in the intervention.¹⁴

The US Preventive Services Task Force found insufficient evidence to recommend brief counseling for obese adults, nor any counseling for overweight adults. However, they did recommend high-intensity counseling for dietary change and exercise to obese adults; this counseling is likely to produce modest sustained weight loss.¹⁵