Cognitive behavioural therapy for obesity: one-year follow-up in a clinical setting

Eat Weight Disord. 2003 Sep;8(3):188-93. doi: 10.1007/BF03325012.

Abstract

Cognitive behavioural therapy (CBT) is the most comprehensive means of medically treating obesity, but only few data have so far been published concerning its long-term effectiveness. We here report our experience of 1068 consecutive patients (868 females) treated with CBT at a university-based obesity centre. The patients were enrolled into three different programmes: a 14-week LEARN programme (672 patients), a 16-week MOB programme for the morbidly obese (259 patients), or a 20-week BINGE programme for subjects affected by binge eating (137 patients). Eighty-five percent of the subjects completed the weekly programmes. The percentage of patients attending the scheduled control visits during the 1-year follow-up gradually decreased, being very low in the BINGE group (10%). The percentage weight loss was an average of 6% during the weekly courses, being higher in the MOB programme; by the end of the weekly sessions, it exceeded 10% of initial body weight in 22% of cases and increased to 36% during the follow-up. The cumulative probability of follow-up was higher among the patients undergoing the MOB and LEARN programmes than among the BINGE patients (p < 0.0001), and decreased with the increasing severity of obesity. Female gender and a weight loss of > 10% i.b.w. increased compliance to follow-up. The study further demonstrates the difficulty of achieving compliance to chronic management of obesity and the critical role of binge eating disorder in the medium-term treatment of obesity. Strategies are needed to improve adherence to a follow-up protocol.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Analysis of Variance
  • Body Mass Index
  • Bulimia / psychology
  • Bulimia / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Cognitive Behavioral Therapy / standards
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Obesity / psychology
  • Obesity / therapy*
  • Obesity, Morbid / psychology
  • Obesity, Morbid / therapy*
  • Patient Care Team
  • Patient Compliance / psychology
  • Patient Education as Topic
  • Problem Solving
  • Program Evaluation
  • Proportional Hazards Models
  • Severity of Illness Index
  • Treatment Outcome
  • Weight Loss