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Table 2 Overview of the content of the lifestyle intervention

From: A three-component cognitive behavioural lifestyle program for preconceptional weight-loss in women with polycystic ovary syndrome (PCOS): a protocol for a randomized controlled trial

Session

Topic

Objectives

1

Introduction

Introduction of the therapists and the group members.

Agreement on attendance, commitment, homework assignments, privacy and buddy system.

Providing information about the program and target weight.

Providing information about the concept of energy balance.

Explaining the link between thoughts, feelings and behaviors.

2-4

Diet: Explaining the Dutch food guide and daily amounts

Psychology: introduction of cognitive behavior therapy

Providing information about the Dutch Food Guide (DFG).

Increasing or decreasing daily amounts based on the Dutch Food Guide (DFG)

Identifying unhealthy food choices.

Understanding the rationale of cognitive behavior treatment.

Completing a thought record. Setting realistic goals (proactive coping).

5

Partner and social support meeting

Welcome to spouses (or family/friends)

General introduction of the lifestyle program for spouses (or family/friends).

How to be supportive in a helpful way.

Providing information about the concept of energy balance.

6,7

Diet: Reading food nutrition labels

Psychology: Biased perception and interpretation

Participants are able to read food nutrition labels.

Making healthier choices based on food nutrition labels.

Identifying and correcting biased perception and interpretation.

8

Dealing with infertility

Sharing emotions concerning infertility.

Reframing negative thoughts concerning infertility.

9,10

Binge eating

Learning different incentive values of food.

Obtaining a regular eating pattern (breakfast, lunch and dinner).

Knowing the difference about hunger, appetite sensations and binge eating.

11

Partner and social support meeting

Using different preparation techniques for cooking.

Asking help from spouses.

12

Binge eating

Finding alternate ways to handle binge eating

Eating healthy portion sizes.

13

Diet: dealing with the holidays or special occasions

Psychology: Behavioral experiment

Making a meal plan for the holidays.

Explaining the rationale for behavioral experiments.

Setting up behavioral experiments.

14

Mindful eating

Knowing the difference between conscious and unconscious eating.

Introduction of mindfulness techniques.

15

Diet: Snacks

Psychology: Relapse prevention

Learning the difference between healthy and unhealthy snacking.

Identifying difficult moments and finding alternative thoughts.

Reframing dysfunctional cognitions concerning relapse.

16

Diet: Eating in a restaurant

Psychology: assertiveness

Eating a healthy meal in a restaurant.

Performing a roll-playing game in a restaurant.

Saying no in a food related situation.

17

Partner and social support meeting

Doing the healthy eating quiz.

Doing a cue exposure exercise involving sweets and cookies.

18,19

Diet: Healthy pregnancy

Psychology: Relapse prevention

Identifying and preventing relapse moments.

Developing self-efficacy beliefs for the future.

Dealing with food and appetite sensations during pregnancy.

20

Evaluation of the program

Relapse prevention

Evaluation of the lifestyle program and participants progress.

Providing information about long-term weight maintenance.

Coping with regaining weight.