mind over matter: using psychotherapy to help treat chronic obesity

margaret kew began noticing a change in her body not long after the birth of her twins.kew, a longtime educator and retired vice-principal with the halton district school board, says she tried everything to keep the weight at bay — lots of “famous programs,” along with regular exercise and a variety of diets. nothing worked.“i would be slightly successful and then i would give up. it was very confusing,” says kew, who, like many working parents, had precious little time to focus on her own health and wellbeing over the years. the turning point came after she saw an old friend at a work conference and was left reeling by the encounter.“she looked fantastic,” kew recalls. “her skin was glowing and she looked so happy. i asked her how it happened, and she spoke about her work with dr. sasha high.”dr. high, an expert in treating obesity and metabolic diseases, is medical director of the mississauga-based high metabolic clinic. the clinic’s mandate is to provide “expert and compassionate care for people living with increased weight and obesity.” most patients enter a one-year program, with additional support as needed. the clinic is fully virtual and able to serve patients across ontario.when it comes to fighting chronic obesity, psychological interventions are a key aspect of the clinic’s treatment program. in other words, using cognitive behavioural therapy (cbt) or “mindset coaching,” as dr. high often refers to it, as part of a multi-pronged approach to treating obesity that also includes registered dietician support, medical treatment, and health behaviour counselling.“mindset coaching is based on the notion that our behaviours are a direct result of our thinking,” she begins. “many people have cognitive distortions that drive actions or behaviours that actually lead them away from the person they want to be and how they want to behave.”mindset coaching shines a light on a person’s cognitive distortions, also known as “tricky thoughts,” dr. high explains. it helps them reframe these thoughts in a way that better serves their overall health. once their thinking is framed more positively, helpful actions are likely to follow.for example, many people carry underlying thoughts like “i’m not worthy.” this subconscious thought can then drive behaviours like not prioritizing their own self-care, or self-sabotaging their efforts to lead a healthier lifestyle. uncovering these thoughts and reframing them will make it more likely for a person to live out actions that align with their beliefs. “negative thoughts never lead to positive actions,” dr. high explains.

additionally, when a patient becomes aware of the link between reward centres in the brain and the desire to consume sugar-rich, highly-processed foods — particularly when feeling stressed or depressed — they will be better equipped to manage such urges.“most people understand what they should and shouldn’t be eating,” dr. high says, “but how to implement that when you’re stressed, angry, or facing other challenges is another story. learning to identify and reframe those thinking patterns really matters.”many may not realize obesity is a chronic disease. its severity can be based on several factors, including a patient’s emotional health, genetic makeup, sleep habits, medical history, or even certain medications.patients like kew are far from alone. based on a 2018 statistics canada survey, roughly 7.3 million adult canadians are living with obesity. an additional 9.9 million adults were classified as overweight. overall, more than 63 per cent of canada’s total population may be facing increased health risks due to excess weight.with world obesity day taking place on thursday, march 4, dr. high is keen to continue the conversation about obesity and related treatments, and to advocate for a global shift in how we think about obesity as a chronic disease.“there is so much bias in our society that people who have elevated weight are at fault, but there’s a lot more to it,” she says. “i think we need to continue pushing the message that, ‘hey, this disease is rooted in physiology, not poor decisions.’”as for kew, a combination of mindset coaching, pharmacotherapy and support for finding a sustainable lifestyle plan at the high metabolic clinic has resulted in notable improvements in her day-to-day life. since beginning her program in september 2019, she has lost 43 pounds and seen notable improvements in blood sugar levels and other physiological markers of success.most importantly, it has granted her the freedom to resume a busy, fulfilling retirement with her husband. “i enjoy being active outdoors, and i can hike much better now. i even took up kayaking and organic vegetable gardening this year,” she says. “obesity finally makes sense now, and it was such a relief and so liberating to go through this process. i am not weak. i am strong.”this story was created by content works, postmedia’s commercial content division, on behalf of a research-based pharmaceutical company.