Michael J. Cameron, Ph.D., BCBA Chair, Department of Behavior Analysis Simmons College, Boston, MA

1. A Behavioral Medicine Approach to Weight Control and Optimal Health March 13, 2010 Michael J. Cameron, Ph.D., BCBA Chair, Department of Behavior Analysis Simmons College, Boston, MA

2. Behavioral Medicine • Behavioral medicine encompasses a philosophy of individual responsibility for disease prevention and health promotion and maintenance • It focuses on an integration of knowledge from the behavioral and biomedical sciences to reach solutions to practical problems of physical health and illness

3. Areas of Research • Assessment and treatment of migraines • Treatment of chronic pain • Childhood obesity • Type I and Type II diabetes management • Exercise promotion and adherence • Caffeine abuse (St. Caffeine) • Cardiovascular functioning • Working within the respondent and operant paradigm

4. Practical Problem: Adult Obesity

6. State of the Science for the Behavioral Treatment of Obesity: Ten Stage • Structural and functional assessment of eating behavior • Stage 1: Comprehensive baseline assessment

9. Stage 2 • Self monitoring • Caloric intake • Fat intake • Time of day • Taste preferences (sweet, sour, salty, bitter savory), food texture preference, temperature preferences, and food volume preferences • Inter-meal/snack intervals • Trigger analysis (high risk events)

10. Stage 3 • The Motivational Interview • Analysis of data and self-identification of problems and patterns • A review of the essential behavioral repertoire • Grocery shopping • Food preparation • Meal and snack planning • Assessment and preference-based exercise plan • SMART goals: Specific, Measurable, Achievable, Realistic, and Timely

11. Stage 4 • The Behavioral Community • Correspondence training (Say-Do-Report) • The daily proclamation and stimulus control

12. Stage 5 • Virtual Behavioral Coaching • Data sharing • Data analysis

13. Stage 6 • Rituals, Routines, and Behavioral Rehearsals • Response interruption strategies (beginning with low preference foods) • The exercise habit and stimulus control • Matched stimuli and food preferences • Education centered on food groups, nutrition, serving sizes • Eating patterns of healthy peers • A review Skinners’ nine essential strategies for self-control (e.g., changing the stimulus, manipulating emotional conditions, deprivation and satiation)

14. Stage 7 • Stimulus Control and Motivating Operations • The Satiety Index (food, abolishing operations, and systematic manipulations) • Self-control through trigger analysis • Physiology of eating behavior • The Food Craving Inventory • Emotions and eating behavior

15. Stage 8 • Exercise and Intensity Shaping • Cardiovascular, strength, and flexibility training • Successive approximations to optimal health

16. Stage 9 • Relapse Prevention and Sustainable Change • Tacting high emotion and risk • The warning signs of risk • Analysis of caloric variation • Vacation and holiday planning • Smoking cessation

17. Stage 10 • Recovery Plan • Defining a “set-back” before it occurs • Structured plans for step-by-step recovery • Review of a comprehensive biopsychosocial model that helps understand the craving process • Developing a log to record personal successes • 3500 claories/1lb (caloric restriction and exercise) • Re-calculating your metabolic rate • Establishing criterion for the implementation of a recovery plan • Review of a developmental model of recovery • Relapse Support Groups

18. Behavioral Medicine • Integration of the basic principles • An area for behavioral analysts