Linda Craighead

SPEECHES

 

 

IN CONGRESS WORKSHOP I

Incorporating Appetite Awareness Traininginto CBT for adult and child weight management

Appetite Awareness Training (AAT) is a strategy designed to restore a more natural feeling of control over eating by training individuals to be aware of, and then to use, internal cues of moderate hunger and fullness to regulate their eating rather than responding primarily to internal emotional cues or external environmental cues or attempting to follow rigid food plans or diet rules. AAT discourages "getting too hungry” as well as "getting too full", focusing on normalizing amounts eaten before targeting changes in food type. Originally designed to reduce binge and overeating without prescribing specific food plans, AAT has been successfully incorporated into comprehensive lifestyle weight management programs, including several designed to target specific health conditions. AAT provides a flexible, individualized guideline to address the need for portion control without promoting feelings of hunger or deprivation. Importantly, written appetite monitoring is deliberately faded to a mental monitoring process at the end of treatment providing a way to maintain accountability once food monitoring is terminated. For patients who initially resist food monitoring, appetite monitoring is a less aversive first step that can enhance motivation to address food type. In addition, a family-based intervention targeting overweight or obese children now being used in several clinical settings will be described. Child-friendly metaphors are used to help parents talk with their kids in a positive way to promote healthy eating habits.

Learning Objectives:

  1. Be able to present the rationale for incorporating appetite awareness training in weight management programs
  2. Be able to instruct an adult or child in the use of appetite self-monitoring
  3. Be able to teach parents how to approach weight management with children in a positive way, empowering the child to take responsibility for their health

Recommended reading:

 

IN CONGRESS WORKSHOP II

Incorporating Appetite Awareness Training into cognitive behavioral treatment for binge eating and bulimia

Appetite Awareness Training (AAT) is designed to restore a more normal feeling of control over eating by training individuals to be aware of, and then to use, internal cues of moderate hunger and fullness to regulate their eating, thereby reducing eating in response to internal emotional cues or external environmental cues. This approach reduces the need to rely on "diets” or "food rules”. By discouraging "getting too full” as well as "getting too hungry" appetite monitoring moderates restraint in a way that feels safe to clients worried about weight gain. First, AAT emphasizes establishing an internal "amount boundary” using a novel form of self-monitoring that incorporates prominent visual cues. Clients typically report that AAT feels "different” from food monitoring and is more useful.This written monitoring is gradually faded to mental monitoring by the end of treatment to promote maintenance of accountability and reduce risk of relapse. The use of traditional CBT food monitoring is optional and can be eliminated for patients who report either excessive dependence on it or who report that it increases their preoccupation with food type. However, a type of food monitoring called food awareness training can be incorporated if needed to address concerns about food type or if weight loss is targeted once binge eating is eliminated. Cases will be presented illustrating AAT to address concerns related to binge and overeating (with and without purging) and excessive preoccupation with food type.

Learning Objectives:

  1. Be able to present the rationale for this expanded model of treatment, describing seven maladaptive cycles that maintain disordered eating patterns
  2. Be able to instruct a client in the use of appetite self-monitoring forms
  3. Understand how to utilize this approach as guided-self-help, as a group intervention, or as part of a broader individual treatment plan for more complex or chronic problems

Recommended reading: