Unrealistic Weight Goals Module

Satisfaction with the amount of weight lost is one the most critical factors involved in long-term body-weight maintenance. Moreover, a decline in weight-loss satisfaction about 4 to 5 months after starting the treatment is associated with poor long-term weight-loss outcomes. To address these obstacles to weight maintenance, cognitive behavior therapy (CBT) for binge-eating disorder (BED) includes the Unrealistic Weight Goals module, designed to help patients who report “unsatisfactory” weight loss 4–5 months from the start of treatment to arrive at the beginning of the weight-maintenance phase in Step Three satisfied with the weight they have reached. Patients who report a decline in weight-loss satisfaction, assessed session by session via the Weight-Loss Obstacles Questionnaire, are helped to identify the reasons behind their weight-loss dissatisfaction. These reasons generally fall into two main, often interrelated, categories: unrealistic weight-loss expectations and/or dysfunctional primary reasons for weight loss. The goal is to encourage the patient to achieve positive acceptance of their body shape and the weight they have reached with the treatment, balancing change and acceptance—changing what can be changed (lifestyle) and accepting what cannot (i.e., achieving an “ideal” body shape and weight).