Dr. Raman is a Research Fellow at the Graduate School of Health-Clinical Psychology, University of Technology Sydney. She is also the Head of Behavioural Health- Research & Practice at the Bariatric and Metabolic Institute at Double Bay, Sydney, Australia. She is an experienced clinical psychologist, fully endorsed and accredited by the Psychology Board of Australia (PBA) to practice and supervise in Clinical Psychology. Dr. Raman has worked extensively in adult mental health in the NSW public and private sectors. Prior to her PhD, she was employed as the Manager- Psychology, Counselling and Discharge Planning departments / Senior Clinical Psychologist at Mount Wilga Private Hospital, NSW, Australia.
Funded by a prestigious Fellowship from the NSW Institute of Psychiatry and a project grant from the Diabetes Australia Research Trust (DART 2014) she was awarded her PhD in September 2016 on the psychological and neuro-cognitive aspects of obesity. Dr.Raman’s PhD comprised of two studies: a cross sectional study testing the contribution of cognitive deficits to obesity in a mathematical model that she developed during her PhD, as well as a novel randomized controlled intervention trial (RCT) of cognitive remediation therapy in adult obesity, the findings from which confirmed the urgent need for prevention and treatment strategies in individuals with obesity
Dr. Raman also teaches and provides research and clinical supervision to trainees enrolled in the Master of Clinical Psychology programme at the UTS. passion lies in translational research in behavioural addictions. She continues to practice as a clinician and is connected to the real world through regular public lectures and media.
ACPA (Australian Clinical Psychology Association) Founding Member
Member, Academy of Eating Disorders (AED)
Endorsement by Psychology Board of Australia in the area of Clinical Psychology
Approved by the Psychology Board of Australia as a Clinical Supervisor
Can supervise: YES
Dr. Raman’s current research interests are in bench to practice translational research. She ha a special interest in developing novel cross-sectional, cohort and RCT intervention studies. She is particularly interested in the psychological and neuropsychological mechanisms that underlie habit and temptation in treatment resistant behaviours. She is also interested in developing internet based interventions for those with behavioural addictions.
She is currently leading an intervention study targeting both the cognitive process (through cognitive remediation therapy) and cognitive content (cognitive-behavioural therapy) that aims to aid individuals with obesity in weight loss and maintenance.
Research Interests- Key Words: Obesity and overweight; Problematic pornography use; Screen based addictions; Problem gambling; Habit; Temptation; Psychological and neuropsychological aspects of treatment resistant behaviours; Cognitive remediation
Current Student Projects
Master of Clinical Psychology:
Ms. Alanna Wong (2016-2017). Cognitive Remediation Therapy for Depression: A case series pilot
Dr. Luke Vu (2016-2017). Self-regulation in pornographic use
Ms. Katie Wood (2016-2017). Examining the relationship between weight and depression in individuals with overweight
Ms. Melinda Clark (2016-2017). Manualised cognitive remediation therapy (CRT) for individuals with overweight: A case series pilot.
Ms. Mary Gilbert (2017-2018) Cognitive remediation enabled cognitive behavioural therapy for obesity
Ms. Julianne Mascarenhas (2017-2018): Self regulation - Cognitive behavioural therapy (SR-CBT) for obesity
Ms. Ilana Cohn (2017-2018): Cognitive remediation therapy for Binge Eating Disorder
Ms. Kathryn Jones: (2017-2018): Eating disorder symptoms after bariatric procedure
Ms.Katherine Saunders: (2017-2018): Emotional Eating in Eating Disorders
Mr. Dean Spirou (2017-2018): Cognitive function in gambling disorders
PURPOSE:Despite varied treatment effects, weight recidivism is common and typically associated with the abandonment of prescribed weight management strategies. Literature suggests that difficulty with weight management is associated with deficits in executive functioning, in particular cognitive flexibility and response inhibition, the neurocognitive processes that are involved in goal-directed behaviours, such as dietary adherence. These processes are overlooked by mainstream weight loss programmes. The aim of the study was to assess the effectiveness of a cognitive remediation-enabled cognitive behaviour therapy (CR-CBT) in addressing the neurocognitive, psychological and behavioural correlates of weight loss. It was hypothesised that CR-CBT would improve cognitive flexibility and response inhibition, reduce binge eating, aid weight loss and improve metabolic health. METHODS:Four adults with obesity (body mass index > 30 kg/m2) received 7 weeks of manualised CR-CBT and were assessed via a case series analysis at baseline, end of treatment and 3-month follow-up. Treatment included 3 weekly 90-min group-based behaviour weight loss sessions for 3 weeks, followed by twice-weekly 50-min individualised CR-CBT sessions for 4 weeks. RESULTS:Cognitive remediation-enabled cognitive behaviour therapy produced improvements in response inhibition and cognitive flexibility, and reductions in binge eating frequency, weight, and metabolic health readings between baseline and 3-month follow-up. CONCLUSIONS:This is the first study to assess the effectiveness of CR-CBT in the treatment of obesity. Preliminary indications of treatment success are discussed with respect to study limitations. In light of these results, we recommend further investigation via a randomised control trial (RCT). LEVEL OF EVIDENCE:Level IV, case series.
Cohn, I, Raman, J & Sui, Z 2019, 'Patient motivations and expectations prior to bariatric surgery: A qualitative systematic review.', Obesity reviews : an official journal of the International Association for the Study of Obesity, vol. 20, no. 11, pp. 1608-1618.View/Download from: Publisher's site
Bariatric surgery is the most effective treatment for weight loss in individuals with severe and complex obesity. While the extant literature has mostly explored clinical outcomes of surgery, recent research has also examined patients' experiences prior to treatment. This systematic review synthesized findings from qualitative studies investigating patients' motives and expectations prior to undergoing bariatric surgery for weight loss. Twenty-eight studies published in English involving 580 participants were identified for inclusion. Data extraction and thematic synthesis yielded four global themes: physiological, emotional, cognitive, and interpersonal/environmental. These represented seven subthemes describing patients' presurgery experiences: relationship with food, physical health, activities of living, personal identity, social relations, presurgery information, and beliefs about surgery. In addition to improving physical and medical comorbidities associated with obesity, participants believed that postsurgery weight loss would produce positive psychosocial impacts by strengthening their personal identities, their relationships, and improving their engagement in public and professional life. The complex and widespread nature of the changes patients expected would result from bariatric surgery highlights the importance of providing pretreatment education focused on psychosocial well-being, as well as concurrent psychological support alongside surgery, to best inform individual treatment selection and clinical practice.
Allom, V, Mullan, B, Smith, E, Hay, P & Raman, J 2018, 'Breaking bad habits by improving executive function in individuals with obesity', BMC Public Health, vol. 18, no. 1.View/Download from: Publisher's site
© 2018 The Author(s). Background: Two primary factors that contribute to obesity are unhealthy eating and sedentary behavior. These behaviors are particularly difficult to change in the long-term because they are often enacted habitually. Cognitive Remediation Therapy has been modified and applied to the treatment of obesity (CRT-O) with preliminary results of a randomized controlled trial demonstrating significant weight loss and improvements in executive function. The objective of this study was to conduct a secondary data analysis of the CRT-O trial to evaluate whether CRT-O reduces unhealthy habits that contribute to obesity via improvements in executive function. Method: Eighty participants with obesity were randomized to CRT-O or control. Measures of executive function (Wisconsin Card Sort Task and Trail Making Task) and unhealthy eating and sedentary behavior habits were administered at baseline, post-intervention and at 3 month follow-up. Results: Participants receiving CRT-O demonstrated improvements in both measures of executive function and reductions in both unhealthy habit outcomes compared to control. Mediation analyses revealed that change in one element of executive function performance (Wisconsin Card Sort Task perseverance errors) mediated the effect of CRT-O on changes in both habit outcomes. Conclusion: These results suggest that the effectiveness of CRT-O may result from the disruption of unhealthy habits made possible by improvements in executive function. In particular, it appears that cognitive flexibility, as measured by the Wisconsin Card Sort task, is a key mechanism in this process. Improving cognitive flexibility may enable individuals to capitalise on interruptions in unhealthy habits by adjusting their behavior in line with their weight loss goals rather than persisting with an unhealthy choice. Trial registration: The RCT was registered with the Australian New Zealand Registry of Clinical Trials (trial id: ACTRN12613000537752).
Raman, J, Hay, P, Tchanturia, K & Smith, E 2018, 'A randomised controlled trial of manualized cognitive remediation therapy in adult obesity.', Appetite, vol. 123, pp. 269-279.View/Download from: Publisher's site
Research has indicated that individuals with obesity have neurocognitive deficits, especially in cognitive flexibility that may in turn impact on their weight loss and maintenance. Consequently, we examined the efficacy of a manualised face-to-face cognitive remediation therapy for obesity (CRT-O) within a randomised controlled trial, in terms of improving cognitive flexibility, reducing binge eating behaviour, improving quality of life and helping with weight loss.80 adults with obesity (body mass index >30 kg/m2), 70% binge eaters, received three weekly sessions of group Behavioural Weight Loss (BWL) and then were randomised to 8 sessions of individual CRT-O or to a no-treatment control group.Mixed-effects model analyses revealed that the CRT-O group had a significant improvement in their cognitive flexibility at post-treatment and 3-month follow-up compared to the control group (Cohen's d = 0.96 to 2.1). 68% of those in the CRT-O group achieved a weight loss of 5% or more at follow-up compared to only 15% of the controls (Cohen's d = 1.3). Changes in set-shifting predicted changes in weight (p < .05). Binge eating reduced in the CRT-O group compared to the control (Cohen's d = 0.80).This is the first study showing the efficacy of CRT-O for obesity. Future CRT-O studies with longer follow-ups and pairing it with longer BWL programs are needed.12613000537752.14 May 2013.
Burton, AL, Hay, P, Kleitman, S, Smith, E, Raman, J, Swinbourne, J, Touyz, SW & Abbott, MJ 2017, 'Confirmatory factor analysis and examination of the psychometric properties of the eating beliefs questionnaire', BMC PSYCHIATRY, vol. 17.View/Download from: Publisher's site
Raman, J, Hay, P & Smith, E 2014, 'Manualised Cognitive Remediation Therapy for adult obesity: study protocol for a randomised controlled trial.', Trials, vol. 15, pp. 1-9.View/Download from: Publisher's site
BACKGROUND: Research has shown that obese individuals have cognitive deficiencies in executive function, leading to poor planning and impulse control, and decision-making difficulties. An intervention that could help reduce these deficits and in turn help weight loss maintenance is Cognitive Remediation Therapy for Obesity (CRT-O). We aim to examine the efficacy of manualised CRT-O, which is intended to improve executive function, enhance reflective practice and help weight loss maintenance. METHODS/DESIGN: A randomised controlled trial (registered with the Australian New Zealand Clinical Trials Registry) will be conducted. First, 90 obese adults (body mass index >30 kg/m2) in the community will receive three weekly sessions of a group Behaviour Weight Loss Treatment (BWLT), and then will be randomised either to receive CRT-O or to enter a no-treatment control group. CRT-O training will comprise twice-weekly sessions of 45 minutes over a 4 to 6 week period, for a total of eight sessions. Measurement points will be at baseline, post CRT-O (or 4 to 6 weeks after BWLT for the no-treatment control), 3 months post treatment and 1 year post treatment. The primary outcome will be executive function and secondary outcome measures will include participants' body mass index, hip to waist ratio, eating behaviours and quality of life. DISCUSSION: This is the first study of its kind to examine the efficacy of Cognitive Remediation Therapy for obese adults through a randomised controlled trial. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry number: 12613000537752. Date of registration: 14 May 2013.
Raman, J, Smith, E & Hay, P 2013, 'The clinical obesity maintenance model: an integration of psychological constructs including mood, emotional regulation, disordered overeating, habitual cluster behaviours, health literacy and cognitive function.', Journal of Obesity, vol. 2013, pp. 1-9.View/Download from: Publisher's site
Psychological distress and deficits in executive functioning are likely to be important barriers to effective weight loss maintenance. The purpose of this paper is twofold. First, in the light of recent evidence in the fields of neuropsychology and obesity, particularly on the deficits in the executive function in overweight and obese individuals, a conceptual and theoretical framework of obesity maintenance is introduced by way of a clinical obesity maintenance model (COMM). It is argued that psychological variables, that of habitual cluster Behaviors, emotional dysregulation, mood, and health literacy, interact with executive functioning and impact on the overeating/binge eating behaviors of obese individuals. Second, cognizant of this model, it is argued that the focus of obesity management should be extended to include a broader range of maintaining mechanisms, including but not limited to cognitive deficits. Finally, a discussion on potential future directions in research and practice using the COMM is provided.
Collaborations are underaway with
· Bariatric & Metabolic Institute, Sydney, Australia (formerly Gastric Balloon Australia)
· University of London (Institute of Psychiatry:Dr. Kate Tchaturia, Reader in the Psychology and Eating Disorders)
· Neuroimaging and Human Cognition, Aquitaine Institut for Cognitive and Integrative Neuroscience, Bordeaux, France
· Institut Benjamin Delessert’ (see : http://www.institut-benjamin-delessert.net/fr/)
· Norwegian University of Science and Technology