PSY 325 1st Edition Lecture 10 Outline of Current Lecture I. Treatment of Substance Use Disordersa. Basic Principles (OARS)II. Weight Maintenancea. Digestive System (briefly)b. Factors involved in weight maintenanceIII. Overeating and Obesitya. Obesityb. Binge Eating Disorderc. Health ConsequencesIV. Theories of obesityV. Weight Lossa. Dietingb. Weight loss strategiesc. Maintaining Weight LossVI. Eating DisordersVII. Anorexia NervosaVIII. Bulimia NervosaIX. Causal Factors X. BiologicalXI. SocioculturalXII. PsychologicalXIII. TreatmentCurrent LectureTreatment of Substance Use Disorders12 steps of AA (it has been around for 60 years)1) Admit you have a problem 2) Believe that there is a higher power out there that controls our livesThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.Motivational interviewingUsing what the client says to develop discrepancies (cognitive dissonance) and eliciting self-change talk.Basic Principles: OARSo Open-ended questionso Affirmationo Reflective Listeningo SummarizingGoal is to get Cognitive Dissonance—will lead to either change beliefs or change behaviors. The latter is the goalOther Techniques (Commonly used but not the only ones)- Decisional Balance Sheet—Pros and Conso Trying to elicit self change statements- Motivation and Confidence Rulero 0-10 how likely is it that you can change your drinking? Get people talking about the positives of why they think they can change.o Effective in changing resistance in treatment, people who really don’t want to be thereo Open-ended questions “tell me more about that”Change Plan—once motivation is high, implement a change planFostering internal motivation can be enough to target these drinking and drug problems.All work equally well when it comes to treatment. Project match data showed trait hostility and aggression did better with motivational interviewing. Doesn’t confront individual, uses information to foster emotional change. There are three equally effective treatments so people now have a choice (spiritual skill stepped, motivational issues, etc.)• Rates of recovery vary considerably• Recognition of problem, adequate treatment facilities available, regular sessions, positive relationship with therapists all help improve outcomes• Relapse• Most relapses occur within 90 days of end of treatment program• After 12 months, only 35% are still abstinent• Continued treatment and follow-ups may prevent relapse• Relapse PreventionWeight MaintenanceThe Digestive System Food nourishes the body by providing energy for activity Digestion begins in the mouth Salivary glands provide moisture that allows food to have taste Food is swallowed and then moves through the pharynx and esophagus Peristalsis moves food through the digestive system In the stomach, food is mixed with gastric juices so it can be absorbed by the small intestineMost nutrients are absorbed in the small intestine. The large is just responsible for reducing the fluids it accumulates during the digestion process.Weight MaintenanceWeight equation includes 3 factors- Calories eaten- Calories used in basal metabolism (resting metabolism)- Calories expended through physical activityStable weight occurs when calories eaten equal those expanded for body metabolism and physical exercise.Part of reason why it’s not that simple is metabolic rate can differ drastically. Signals can vary orbe disrupted in some individuals or not. One of the most important is Leptin. Signals when food is needed. When fat storage becomes low, sends signal to hypothalamus, indicates hunger. This complicates our understanding of those who overeat, are overweight or are underweight. Factors in Weight Maintenance◦ Metabolic rates differ from person to person◦ Neurotransmitters and Hormones◦ Leptin, a protein, signals when more food is needed◦ Insulin, a hormone, helps the hypothalamus understand when we have eaten enough food◦ Ghrelin, a hormone, stimulates appetite and decreases metabolism◦ Serotonin – appetite suppressant Experimental Starvation - Keys and colleagues (1950)◦ Restricted caloric intake to half of their normal◦ Men lost weight rapidly, but that pace slowed and required them to eat less to continue losing weight ◦ Lasted 6 months◦ Results◦ Showed that too much weight loss leads to irritability and aggression◦ Preoccupation with food◦ Body slows metabolism to adjust for calorie restriction ◦ Regaining the weight – permitted to eat as much as they wanted – all regained the weight all regained the weight and some slightly overweight◦ Many still had an obsession over food—were craving food all the timeThese participants were normal weight, average to above average IQs, were emotionally stable,everyday guys. They restricted caloric intake to half of their normal. The goal was to get them tolose 25% of their body weight. Initially they lost weight quickly but that slowed tremendously but that slowed tremendously. Metabolic rate slowed down a lot. Skipping meals therefore slows metabolic rates. Study lasted 6 months. After study allowed individuals to regain their weight. They allowed them to eat as much as they wanted. All regained their weight. Some became slightly overweight, to what their baseline was. Even when back to normal weight, had cravings for food. Psychological factors were being shown.So what happens when you are forced to overeat?◦ Experimental Overeating (Sims and colleagues , 1973)◦ Participants were prisons in a Vermont State Prison◦ Instructed to gain 20-30 pounds ◦ At first gain weight easily, but required greater caloric intake to keep gaining weight◦ Showed that too much eating leads people to become uninterested in eating◦ Normal weight individuals have trouble increasing their weight substantially and that, even if they do, they have difficulty maintaining itThey were isolated in an environment that had tons of delicious foods. One person had 10,000 calories a day and still did not reach weight gain goal. As the study went on, participants found it to become uncomfortable and showed too much eating leads people to become disinterestedin eating. This has a lot of implications about how we go about defining obesity. Weight loss and weight gain are both difficult to do. Overeating and Obesity What is obesity?◦ Overeating is NOT the sole cause of