Personalized group cognitive behavioural therapy for obesity: a longitudinal study in a real-world clinical setting

Eat Weight Disord. 2020 Apr;25(2):337-346. doi: 10.1007/s40519-018-0593-z. Epub 2018 Oct 10.

Abstract

Purpose: Severe obesity is difficult to treat, and non-surgical treatment is not supported by robust evidence. The aim of the present study was to establish the immediate and longer-term outcomes following "personalized" form of group cognitive behavioural therapy for obesity (CBT-OB)-a new treatment designed to address specific cognitive processes that have been associated with attrition, weight loss, and weight maintenance in previous studies.

Methods: Sixty-seven adult patients with obesity (body mass index (BMI) ≥ 30 kg/m2) were recruited from consecutive referrals to an Italian National Health Service obesity clinic. Each patient was offered 22 group sessions of CBT-OB (14 in the 6-month weight-loss phase and 8 in the subsequent 12-month weight-maintenance phase).

Results: 76.2% patients completed the treatment, with an average weight loss of 11.5% after 6 months (10% in the intention-to-treat analysis) and 9.9% (7.5% in the intention-to-treat analysis) after 18 months. Weight loss was associated with a significant reduction in cardiovascular risk factors, anxiety, depression, and eating disorder psychopathology, and an improvement in obesity-related quality of life.

Conclusions: These findings provide strong preliminary support for the use of CBT-OB for obesity in standard clinical settings, and justify its further evaluation in randomized controlled trials.

Level of evidence: Level III, longitudinal cohort study.

Keywords: Attrition; Cognitive behavioural therapy; Group therapy; Lifestyle modification; Obesity; Weight loss; Weight maintenance.

MeSH terms

  • Adult
  • Aged
  • Anxiety / psychology
  • Blood Glucose / metabolism
  • Body Weight Maintenance
  • Cholesterol / metabolism
  • Cholesterol, HDL / metabolism
  • Cognitive Behavioral Therapy / methods*
  • Depression / psychology
  • Feeding Behavior / psychology
  • Feeding and Eating Disorders
  • Female
  • Glycated Hemoglobin A / metabolism
  • Heart Disease Risk Factors
  • Humans
  • Insulin / metabolism
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity / metabolism
  • Obesity / psychology
  • Obesity / therapy*
  • Psychotherapy, Group / methods*
  • Quality of Life*
  • Treatment Outcome
  • Triglycerides / metabolism
  • Weight Loss
  • Young Adult

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Glycated Hemoglobin A
  • Insulin
  • Triglycerides
  • hemoglobin A1c protein, human
  • Cholesterol