A randomised controlled trial of manualized cognitive remediation therapy in adult obesity

Appetite. 2018 Apr 1:123:269-279. doi: 10.1016/j.appet.2017.12.023. Epub 2017 Dec 24.


Objective: 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.

Methods: 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.

Results: 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).

Discussion: 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.

Trials registry (anzctr): 12613000537752.

Date of anzctr registration: 14 May 2013.

Keywords: Adult obesity; Binge eating; Cognitive flexibility; Cognitive remediation therapy; Executive function; Health related quality of life; Weight loss.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Australia
  • Binge-Eating Disorder / psychology
  • Binge-Eating Disorder / therapy
  • Body Mass Index
  • Bulimia / psychology
  • Bulimia / therapy
  • Cognitive Remediation*
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Obesity / psychology
  • Obesity / therapy*
  • Quality of Life
  • Surveys and Questionnaires
  • Treatment Outcome
  • Weight Loss
  • Young Adult

Associated data

  • ANZCTR/12613000537752