1. Weight management and psychological flexibility Raimo Lappalainen Professor in Clinical Psychology and Psychotherapy Department of Psychology University of Jyväskylä, Finland

2. Behavioral case formulation and motivation for change

3. Impaired Social Relationships Depressive mood Weight Problems: overweight Social Skills Deficits High Caloric Intake: Family/Social Stressors: Relationship with the spouse Limited Exercise Social Isolation Health problems Worried about the future Loss of workplace Negative self-image: Negative thoughts Contextual analyses ”weight in context”: Get a larger picture over the weight management problem

4. Impaired Social Relationships Depressive mood Weight Problems: overweight Social Skills Deficits High Caloric Intake: Family/Social Stressors: Relationship with the spouse Limited Exercise Social Isolation Health problems Worried about the future Loss of workplace Negative self-image: Negative thoughts Contextual analyses: There might be other or additional alternatives for intervention

5. Consider weight or weight management problem in context

6. Model

7. Build individual reinforcers for lifestyle changes

8. Psychological flexibility

9. Essi Sairanen, Raimo Lappalainen, Anja Lapvetela ̈ inen, Asko Tolvanen, & Leila Karhunen (2014). Flexibility in weight management. Eating Behaviors 15, 218–224 The aim was to achieve an understanding about the mechanism of change during weight maintenance, especially related to control and flexibility.

10. Results These results suggest that an increase in flexible control during weight loss and a reduction of rigid control after an active weight loss phase may enhance well-being. In other words, the ability to increase flexible control and ability to give up rigid control may be beneficial to weight management and well- being.

11. Different behavioral change strategies may be needed over time Behavioral Change Strategy 1 Behavioral Change Strategy 2 Behavioral Change Strategy 3

12. Mobile- and web- based interventions Combining mobile- and web – based interventions with some personal contact

13. Vision: Web- and Mobile psychological interventions

14. Training skills in daily life

15. Lappalainen et al. (Accepted): Depression symptoms, Face-to-Face vs. mainly web-based intervention. Behaviour Research & Therapy Web-based Face-to-Face

16. Conclusions Advantages of using case formulation models > broader interventions (Develop) programs for increasing motivation for change Interventions should teach flexible strategies, what are these strategies in practice and how to teach them? Advantages of using web- and mobile- interventions Combine all these together