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Psychonutritional management of overweight and obesity, Part 1
Some of your patients with overweight or obesity do not respond, or no longer respond, to a purely micronutritional approach, because the blocks are psychological before they are metabolic. This training gives you concrete tools to recognise these situations and support these patients towards free, healthy and serene…
6 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
Some of your patients with overweight or obesity do not respond, or no longer respond, to a purely micronutritional approach, because the blocks are psychological before they are metabolic. This training gives you concrete tools to recognise these situations and support these patients towards free, healthy and serene eating behaviour, when lifting the metabolic blocks alone is no longer enough.
What you will learn
- Distinguish, from real clinical cases, when to favour a micronutritional approach and when to begin psychonutritional work, when two patients consult for the same reason.
- Retrace a patient's weight history and help them understand the notions of set-point weight, in order to soften an often conflictual relationship with weight.
- Conduct a cognitive restructuring exercise (the ABCDE grid) to spot automatic thoughts and their filters, extrapolation to the future, exaggeration and demand, which are triggered at the moment of weighing.
- Reconnect the patient to their physical hunger using the hunger scale, de-demonise hunger sensations and differentiate light hunger, true hunger and hypoglycaemia.
- Have them practise mindful tasting to decorrelate pleasure from quantity and reintroduce foods perceived as forbidden.
- Identify and support the seven types of hunger (eyes, nose, mouth, stomach, cells, mind and heart) to respond to them appropriately.
On the programme
- The relationship with weight: weight history, set-point weight, Epictetus's distinction between what depends on the patient and what does not, calculation of the average weight and the limits of BMI.
- Cognitive restructuring: automatic thoughts, identifying distorting filters and working on daily weighing.
- Connecting to physical hunger: the hunger scale, the vase metaphor, monitoring exercise and de-demonising hunger.
- Mindful eating: gathering yourself before eating, doing nothing but eating, and a guided comparative tasting.
- The seven types of hunger: recognition, intensity, mouth hunger, mental hunger and heart hunger, with the free and healthy eater's grid as a follow-up tool.
- Practical exercises, role-plays and audio recordings to reproduce in consultation, as well as concrete benchmarks on the rhythm and organisation of sessions.
Who it is for
This training is for healthcare professionals already familiar with micronutrition, pharmacists, doctors, dietitians and practitioners supporting patients with overweight, obesity or metabolic syndrome, who wish to enrich their management with a psychonutritional dimension.
At the end of the training
You will be able to identify the patients for whom psychonutritional work is a priority and adapt your stance accordingly, setting aside a dietitian's discourse when it reinforces cognitive restriction. You will have structured exercises to soften the relationship with weight, reconnect the patient to their hunger sensations and lead them to eat mindfully. You will also recognise the limits of your scope of practice and the situations that call for referral to a specialist.
Programme
Total video duration: 6 h 38 min
CCM PSYCHONUTRITION VOLET 1 PARTIE 1
- Quiz de début de formation
- Leçon 12 h 28 min
- Leçon 258 min
- Leçon 355 min
- Leçon 42 h 17 min
- Quiz de fin de formation
Video Audio PDF handout
Frequently asked questions
Why address reconnecting with physical hunger before even discussing a meal plan or micronutrition?
Dr Anne Lucas, PharmD explains that we are all born with an internal regulation system, the ponderostat, which maintains an equilibrium weight without conscious control. All diet methods have conditioned patients to ignore their hunger, creating a deep disconnection. Working on this mind-body connection first restores the natural regulator and makes the other nutritional interventions far more effective afterward.
Why not force a patient who isn't hungry in the morning to eat breakfast, in a psychonutritional approach?
In this approach, the goal is to match food intake to real physical hunger cues. Forcing breakfast on a patient who is not hungry can cause heavy digestion and an energy crash, with no benefit. The exception concerns patients with hypothyroidism or anxiety/depressive disorders, for whom micronutritional considerations take priority and breakfast becomes necessary.
Why do two successive tastings (one automatic, one mindful) with the patient?
Comparing the two tastings lets the patient concretely measure the difference in pleasure felt. Dr Anne Lucas, PharmD thus shows that paying three times more attention to the food yields three times more pleasure without increasing the quantity. This is a powerful teaching tool for dismantling the belief that it is the quantity eaten that provides pleasure.
How do you decide whether a patient consulting for overweight needs a micronutritional or a psychonutritional approach?
Dr Anne Lucas, PharmD recommends always starting with micronutrition, which is the core discipline, and observing how the patient responds to the protocol over a few weeks. If she follows it without frustration or loss of control, psychonutrition is not necessary (Nadia's case). If, however, she shows a strong sense of guilt, loss of control, or a history of many diets, the approach must shift to psychonutrition, sometimes stopping all dietary discourse completely (Stephanie's case).
How do you choose between a classic micronutritional approach and a psychonutritional approach in an overweight patient?
The choice depends on the clinical priority. If the patient is locked into cognitive restriction with rigid eating rules, loosening eating behavior takes priority over metabolic correction. Conversely, if health issues (hypothyroidism, anxiety/depressive disorders) are in the foreground, the micronutritional approach applies. The two approaches are not used at the same time: the priority issue is treated first, then the other is addressed.
What is the equilibrium weight, and how is it estimated in consultation?
The equilibrium weight is the weight an individual is genetically programmed for, regulated by a neurobiological and hormonal system called the ponderostat. It corresponds neither to a desired weight nor to a BMI of 25. To estimate it, Dr Anne Lucas, PharmD analyzes: family build, the delta between the lowest and highest weights naturally reached in adulthood, the number of diets undertaken, and the level of physical activity. The larger the delta, the higher the current equilibrium weight has risen relative to its starting level.
How can a patient who eats exclusively according to schedule or context, rather than bodily sensations, be helped?
Dr Anne Lucas, PharmD suggests helping her concretely identify what triggers eating (the time, work rhythm, social beliefs). The analogy of the infant is then used: a baby eats when hungry and stops when full, without looking at the clock or calculating quantities. The goal is to spark curiosity about one's own bodily signals rather than following external rules.
How should the role of aftertaste in regulating food intake be explained to the patient?
After swallowing a fatty or sweet food, the aftertaste (lingering taste) is part of the pleasure and naturally paces food intake. Dr Anne Lucas, PharmD advises waiting for the taste to return to neutral before taking another bite, which slows down the rate of eating and reduces the amounts consumed without any deliberate effort at restriction.
Why do repeated diets irreversibly raise the equilibrium weight?
Each attempt at weight control triggers the ponderostat's defense mechanisms: adipocyte hyperplasia and hypertrophy, creating new adipocytes whose number remains durably stable (difficult to reduce without surgery). The ponderostat incorporates this new mass and tends to raise the reference threshold upward. Dr Anne Lucas, PharmD explains to her patients that this process is hard to reverse: by trying to lose the 2 kg they could not accept, they ultimately end up accepting 6 or 7 more to manage.
What is reactive hypoglycemia, and how should it be explained to the patient?
Reactive hypoglycemia occurs after a meal rich in high-glycemic-load carbohydrates: the postprandial hyperglycemia triggers excessive insulin secretion, which causes blood glucose to drop below the baseline, causing an energy crash, the urge to nap or the need for sugar. It differs from classic hypoglycemia (too long a wait between two meals). The practitioner explains it without demonizing carbohydrates, guiding the patient to build balanced plates so the level returns to baseline after the meal.
How can mild hunger (level 1) be practically distinguished from true hunger (level 2) and hypoglycemia (level 3)?
Mild hunger (level 1) corresponds to slight to moderate stomach signals: light rumbling, a subtle empty feeling. True hunger (level 2, "the quest for the Grail") corresponds to strong to intense signals, still digestive, but much more present, the ideal time to eat. Extreme hunger (level 3) manifests as extra-digestive signals: dizziness, nausea, sweating, mood disturbances, sometimes called "hypoglycemia" in the felt sense, not in the sense of a measured low blood glucose, and it is a danger signal that triggers uncontrollable emergency eating behaviors.
What are the 7 types of hunger presented in this exercise, and how should they be scored?
The 7 types of hunger are: eye hunger (visual), nose hunger (smell), mouth hunger (taste), stomach hunger (physical), body or cell hunger (physiological), mind hunger (mental) and heart hunger (emotional). Each type is scored from 0 to 10 before eating. This exercise, presented by Dr Anne Lucas, PharmD, aims to identify which hunger is behind the urge to eat, in order to respond to it appropriately.
How should a patient who is hypersensitive to hunger sensations and feels an urgent need to eat at the first gurgling be managed?Full answer inside the training →
How should the concept of the set point be explained to a patient?Full answer inside the training →
How should plate composition be discussed without falling back into a "diet" mindset?Full answer inside the training →
How can a patient whose mouth hunger is very strong and often suppressed by past diets be helped?Full answer inside the training →
Which weighing method does Dr Anne Lucas, PharmD recommend, and why?Full answer inside the training →
When is a patient encouraged to eat according to physical hunger, and when are meals eaten in a social context, without level-2 hunger, acceptable?Full answer inside the training →
How should a patient whose "cup overflows" due to emotional eating rather than cognitive restriction be managed?Full answer inside the training →
What strategy should be proposed for trigger hungers (visual and smell) when there is no associated physical hunger?Full answer inside the training →
How does mental hunger (cognitive restriction) show up, and how should it be addressed?Full answer inside the training →
Is a patient who only feels hungry once a day at risk of macronutrient deficiencies?Full answer inside the training →
How should the guilt of a patient who ends up eating large amounts uncontrollably after a hypoglycemic episode be managed?Full answer inside the training →
What is the ABCD grid, and how is it used around weighing?Full answer inside the training →
How should mindful tasting be introduced in a session, and what should the patient be asked to bring?Full answer inside the training →
What is the difference between heart hunger in a healthy eater and pathological behavior?Full answer inside the training →
What are the three most common distorting filters to identify in weight-related thoughts?Full answer inside the training →
How is the physical hunger connection exercise conducted in session, and what instructions are given between sessions?Full answer inside the training →
How can the color-coded food diary be used to identify a patient's dominant hunger types?Full answer inside the training →
Why is the pause for reflection before eating the first skill to develop in mindful eating?Full answer inside the training →
How should a patient be congratulated in a way that does not reinforce hypersensitivity to the scale?Full answer inside the training →
Is this physical hunger reconnection exercise compatible with prescribing intermittent fasting or a restrictive eating window for insulin-resistant patients?Full answer inside the training →
What cardiac coherence protocol is recommended before meals, and which app should be suggested?Full answer inside the training →
How often does Dr Anne Lucas, PharmD recommend spacing out psychonutrition sessions?Full answer inside the training →
How should the frequency of psychonutrition consultations be organized for optimal management of overweight?Full answer inside the training →
How should the notion of food pleasure be decoupled from the quantity eaten?Full answer inside the training →
What should be done when a patient uses psychonutrition sessions as a pretext for cognitive restriction?Full answer inside the training →
When should a patient be referred to a psychologist or cognitive behavioral therapy (CBT) rather than treating emotional eating alone in consultation?Full answer inside the training →