Obesity medications can be life-changing—but lasting success requires more than the biological changes the medication is creating in your body. Long-term success often depends on what happens mentally and emotionally. That’s where Cognitive Behavioral Therapy (CBT) comes in.
CBT is a structured, evidence-based therapy that teaches people to recognize, challenge, and shift unhelpful thinking patterns. In weight management, those patterns might show up as:
- “I messed up today, so I might as well give up.”
- “I’ve had such a tough day– I deserve this treat.”
- “If I don’t lose all the weight I want to, what’s the point?”
CBT helps people replace distorted thoughts like these with ones that are more rational and supportive. Toronto-based weight expert Dr. Sandy Van explains that CBT helps people “capture unhelpful thoughts that generate unhelpful behavior in the context of eating or exercise or self-care strategies.” When we change how we think, we’re more likely to change how we behave.
Why CBT + Medications Work So Well Together
Obesity medications lower appetite and reduce food preoccupation—what Dr. Van calls “food noise.” That gives people cognitive space to start practicing new thought patterns and behaviors.
“[They help] somebody leverage the use of the lifestyle modifications they know that they want to engage in,” she says. “Because they’re less busy in their mind with thoughts about food and preoccupation and cravings and hunger.”
This creates a kind of synergy: medications reduce the biological barriers, and CBT helps people rewire their responses, build structure, and maintain changes. It also helps address one of the most overlooked barriers to success: expectations.
Many people expect dramatic results when they start a medication—like losing 40% of their weight—more typical of surgery than medication.
Dr. Van helps patients shift away from these unrealistic targets and focus instead on progress that’s sustainable and meaningful.
Skills CBT Helps Build
CBT helps people:
- Delay impulsive eating by identifying thought triggers (like “I deserve this after a long day”).
- Set realistic goals and avoid self-sabotage.
- Create supportive home environments by challenging guilt about removing triggering foods.
- Reframe slip-ups as learning opportunities, not failure.
CBT also teaches self-monitoring: tracking food, behaviors, emotions, and thoughts. “Knowledge plus action is what’s going to elicit change,” Dr. Van says. “Tracking helps people learn their patterns, not judge themselves.”
Medications can open the door by rewiring the brain’s typical response to weight loss— increased food noise– but CBT can help you step through that door and keep moving forward.
An important step towards better health for many people is reaching a healthier weight, which can reduce the risk of cardiovascular disease. To find a physician near you who specializes in weight management, click here.
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This article was sponsored by Novo Nordisk Canada. All content is created independently by My Heart – What To Know with no influence from Novo Nordisk.