Counseling and Behavioral Interventions

Behavioral Changes

As discussed in the Obesity Management in Practice section, the behavioral changes that are required for following physical activity and nutritional interventions can be very difficult to make. 

Eating behaviors in people who have overweight or obesity are affected by a wide range of factors, including genetic predisposition, mental stress, emotions, habits, environment, knowledge gaps, reward factors, and psychiatric disease, and can also be influenced by physical conditions such as endocrinopathies (OMA, 2025). Physical activity may be curtailed due to both physical and emotional limitations and factors such as fatigue, disinterest, time constraints, and an unsafe environment (OMA, 2025).

Behavior therapy aims to address these challenges and promote behaviors that are associated with weight loss. A team-based approach to weight management should include frequent encounters with qualified professionals. 

Counseling approaches such as motivational interviewing may be helpful for encouraging patients to adopt healthful changes. Other approaches can include stimulus control, cognitive restructuring, goal setting, self-monitoring, behavioral contracting, problem solving, social support, and contingency management (OMA, 2025). 

Although primary care providers may not have time and training to provide all needed behavioral interventions, they do have opportunities to provide interventions, such as initial motivational interviewing approaches, and can refer appropriate individuals to behavioral therapists (Pennings et al., 2025).

See Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions from the USPSTF for more information about behavioral approaches (USPSTF, 2018). 

Evaluate | Approaches to Implement