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Psychonutritional management of overweight and obesity, Part 2
Cognitive restriction, the mental control that most of your patients exert over their eating, ends up cutting them off from their own sensations and sustains their weight difficulties. This training, which extends Part 1, gives you a concrete approach to pacify the relationship with food, support the patient towards…
4 lessons · Lifetime access · Online
These trainings are delivered in French. This page is translated for your convenience; the course videos and materials remain in French.
Overview
Cognitive restriction, the mental control that most of your patients exert over their eating, ends up cutting them off from their own sensations and sustains their weight difficulties. This training, which extends Part 1, gives you a concrete approach to pacify the relationship with food, support the patient towards their satiety signals and tame emotional eating, using tools drawn from cognitive and behavioural therapies.
What you will learn
- Identify and assess the degrees of cognitive restriction, mild, moderate and severe, and recognise the emotions it induces, fear of running out, fear of cracking, fear of being hungry, guilt.
- Understand and have the patient experience the notions of satiety, sensory-specific satiety and overall satiety, to help them stop eating at the right moment.
- Conduct supervised exercises, the reintroduction of taboo foods, the comparative menu test and the four-day satiety exercises.
- Distinguish the emotions induced by cognitive restriction from extra-dietary emotions, and work on the thought-emotion pair.
- Use a palette of tools for emotional eating, cognitive restructuring (ABCDE grid), mental modes management, mindfulness meditation, cognitive defusion techniques and a comfort-eating protocol.
- Spot the comfort disorder and the abstinence violation, and know how to stay within your scope of practice by referring when the issue goes beyond eating behaviour.
On the programme
- Cognitive restriction, definition, degrees, consequences, and the main clinical situations encountered in consultation.
- Softening cognitive restriction by reconnecting to sensations, with the reintroduction of taboo foods and the comparative menu test around energy density.
- Satiety and satiation, distinguishing the notions and practical exercises to teach the patient to stop eating.
- Emotional eating, the emotions induced by cognitive restriction and extra-dietary emotions.
- The tools of second-wave cognitive and behavioural therapies, cognitive restructuring with the ABCDE grid and mental modes management.
- The third-wave tools, mindfulness meditation on thoughts and cognitive defusion techniques, as well as a presentation of acceptance and commitment therapy and its matrix.
- The comfort-eating protocol, with a guided tasting exercise linking foods, flavours and emotions.
Who it is for
This training is for healthcare professionals who wish to integrate psychonutrition into their practice, doctors, pharmacists, dietitians and other practitioners supporting patients with overweight or seeking a better relationship with food. Part 1 is a prerequisite.
At the end of the training
You will be able to spot and assess a patient's cognitive restriction, explain its mechanisms to them and support them towards reconnecting with their hunger and satiety sensations. You will be able to offer supervised exercises around taboo foods, sensory-specific satiety and comfort eating. You will finally have a palette of tools to work on emotional eating and choose, according to the patient and context, the most appropriate approach.
Programme
Total video duration: 6 h 22 min
CCM SURPOB PSYCHONUT V2
- Leçon 11 h 42 min
- Leçon 21 h 44 min
- Leçon 31 h 23 min
- Leçon 41 h 33 min
Video Audio PDF handout
Frequently asked questions
When should cognitive restructuring be used rather than another approach?
Cognitive restructuring (the ABCDE grid) is indicated when the patient can identify their automatic thoughts and agrees to examine their content. It becomes difficult to use when the patient is completely fused with their thought and perceives it as absolute reality. In that case, Dr Anne Lucas, PharmD, recommends switching to third-wave CBT techniques, which work on the relationship to the thought rather than on its content.
How to explain to a patient the difference between mild, moderate, and severe cognitive restriction?
Mild cognitive restriction corresponds to dietary rules that are generally followed, with food-related emotions perceived but disregarded. Moderate restriction occurs when the patient can no longer maintain these rules, generating guilt, fear of giving in, and fear of running out. Severe restriction is a phase of total decompensation with repeated loss of control and significant distress, requiring more specialized support.
When is it appropriate to offer the comfort-eating protocol to a patient?
This protocol should only be considered after cognitive restriction has been loosened and after mindful tasting has been worked on. Cognitive restriction must be sufficiently lifted so that the patient can comfort herself without guilt. Offering this protocol too early, particularly at the very first consultation, would be counterproductive.
What is the difference between satiety and satiation, and which one should the patient be taught to respect?
Satiation is the process that unfolds during the meal and leads to stopping food intake. It begins with sensory-specific satiety (SSS), meaning the decrease in the taste pleasure perceived in the mouth for a given food; the accumulation of several instances of SSS leads to overall satiation, the true signal to stop eating. Satiety, on the other hand, refers to the state of non-hunger that sets in after the meal and persists between meals. It is therefore satiation, via the perception of SSS, that the patient is taught to perceive and respect during the meal.
Why should a new diet not be given to a patient with cognitive restriction?
Any diet, whatever its approach (keto, low-calorie, intermittent fasting), worsens cognitive restriction by imposing new mental rules that reinforce control. Dr Anne Lucas, PharmD, uses the metaphor of the hole: prescribing another diet is like sending a shovel to dig deeper, instead of a rope to climb out. The goal is to replace mental control with attentiveness to physical hunger sensations.
How much is the patient allowed to eat during a comfort-tasting session?
No maximum quantity should be set in advance. The patient eats the amount necessary and sufficient to restore her emotional balance. By eating mindfully and without judgment, she will always eat just the minimum effective amount. Imposing a limit would amount to a partial permission that keeps the restriction in place.
How to concretely explain sensory-specific satiety (SSS) to a patient?
The patient is asked to focus on the taste pleasure felt with each bite, rated from 0 to 10. When this pleasure starts to decrease significantly compared with the first bite, SSS has been reached for that food, regardless of how much remains on the plate. This threshold is personal: some stop at 7/10, others as soon as the first decline appears. Mindful eating is essential to perceive it.
What are the three main cognitive filters to identify in overweight patients?
Dr Anne Lucas, PharmD, identifies three main filters, the 'three exes': exaggeration (using 'everything,' 'always,' 'never,' 'nothing'), extrapolation toward the future (catastrophic scenarios, future tense verbs or 'going to'), and extrapolation toward the past ('if only'). To these three is added self-demandingness, particularly common in women, which generates guilt and shame, often at the root of compulsive eating behaviors.
Which types of foods have the strongest SSS effect, and why is this clinically important?
High-energy-density foods (fatty-sweet, fatty-salty: cheese, cured sausage, fries, pastries, cooked salmon) show a marked SSS effect: pleasure rises quickly and declines rapidly. Low-energy-density foods (fruits, vegetables) show no SSS effect: it is gastric volume that stops their consumption. This distinction validates the compared-menus test: eating a small amount of an energy-dense food can provide as many calories as a large volume of low-energy foods.
How to explain to the patient why they cannot change their eating behavior through willpower alone?
Dr Anne Lucas, PharmD, uses the metaphor of the padlocked house: compulsive eating behavior is automatic and cannot be modified directly, just as emotion cannot be suppressed on command. The only accessible entry point is thought (box B in the ABCDE grid). Showing this diagram to the patient helps them understand that they are not failing through lack of willpower, but caught in an automatic cascade that they can learn to interrupt upstream.
How can patients be shown that comfort eating does not affect their equilibrium weight?
Comfort eating and physical eating are two distinct homeostatic loops. After a comfort-tasting session, physical hunger returns later and less intensely, which naturally offsets the intake. Weight regulation is not decided over one meal or one day, but over a week to ten days.
What is the mechanism by which fear of running out pushes a patient to overeat?
When a food is classified as forbidden, on the day it is allowed the patient anticipates that they will not be able to eat it again soon. This thought generates fear of running out, which triggers an automatic behavior of maximal consumption without any attention to satiety cues. Once the restriction is lifted, the patient can eat the amount that suits them and stop naturally, because they know they can eat it again whenever they wish.
How to conduct the 4-day single-food exercise to work on SSS in practice?Full answer inside the training →
What is the difference between emotions induced by cognitive restriction and emotions unrelated to eating?Full answer inside the training →
How does Dr Fradin's mental mode management (GMM) complement the ABCDE grid?Full answer inside the training →
How to assess in consultation whether a patient's cognitive restriction has sufficiently eased?Full answer inside the training →
What is the value of the guided six-portion version of the SSS exercise, and in which cases should it be used?Full answer inside the training →
What does the 4-flavor tasting exercise involve, and what is its clinical value?Full answer inside the training →
What is the abstinence violation effect, and how should it be addressed in consultation?Full answer inside the training →
What cognitive defusion techniques can be offered when the patient refuses to reframe a thought?Full answer inside the training →
How can mindfulness meditation be integrated into the management of emotional eating?Full answer inside the training →
What should be done if a patient observes no decrease in pleasure despite the exercise and still eats the entire portion every time?Full answer inside the training →
Why can't the comfort-eating protocol be used indefinitely when there are many emotions unrelated to eating?Full answer inside the training →
What does the taboo-food reintroduction exercise proposed by the GROS consist of?Full answer inside the training →
How to address the belief 'you must not leave food on your plate,' which holds back many patients?Full answer inside the training →
What is ACT (Acceptance and Commitment Therapy) and in what context should it be used in psychonutrition?Full answer inside the training →
What resource does Dr Anne Lucas, PharmD, recommend to support cognitive restructuring work with patients?Full answer inside the training →
Why can two menus with identical calorie values generate very different behaviors in a patient with cognitive restriction?Full answer inside the training →
What is the difference between guilt and shame in the context of emotional eating, and why does it matter?Full answer inside the training →
Where is the boundary between normal emotional eating and pathological emotional eating?Full answer inside the training →
What is the difference between extra-food-related emotions and emotions induced by cognitive restriction?Full answer inside the training →
How can the ACT matrix be used with a patient in a psychonutrition consultation?Full answer inside the training →
When should a patient be referred to a psychiatrist or psychologist rather than continuing psychonutrition follow-up?Full answer inside the training →
What is the notion of values in ACT, and how can it be worked on with the patient?Full answer inside the training →
What behavioral tools can be proposed for emotional hunger, and what are their limitations?Full answer inside the training →
How to use the ABCDE grid to work on toxic thoughts related to eating?Full answer inside the training →