Outcomes and mechanisms of change in cognitive-behavioral interventions for weight loss: A meta-analysis of randomized clinical trials

Loana Comșa; Oana David; Daniel David

doi:10.1016/j.brat.2020.103654

Outcomes and mechanisms of change in cognitive-behavioral interventions for weight loss: A meta-analysis of randomized clinical trials

Behav Res Ther. 2020 Sep:132:103654. doi: 10.1016/j.brat.2020.103654. Epub 2020 Jun 2.

Authors

Loana Comșa¹, Oana David², Daniel David³

Affiliations

¹ Doctoral School of Evidence-based Assessment and Psychological Interventions, Babes-Bolyai University, Cluj-Napoca, Romania.
² International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Republicii Street 37, 400015, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj- Napoca, Romania. Electronic address: oanadavid@psychology.ro.
³ International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Republicii Street 37, 400015, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj- Napoca, Romania; Icahn School of Medicine at Mount Sinai, New York, USA.

PMID: 32683134
DOI: 10.1016/j.brat.2020.103654

Abstract

Objectives: To evaluate the efficacy of CBT in relation to weight loss and related psychological components and to analyze the relationship between alleged cognitive mechanisms of change and weight loss.

Methods: The studies we considered eligible were the randomized clinical trials which included and reported a quantitative assessment of change in weight and of potential cognitive mechanisms of successful change in weight and comparing at least one active CBT intervention with a control for adults.

Results: We included 16 studies (18 contrasts) with a total of 1.663 participants. The pooled ESs in which a CBT-intervention was compared to a control condition for weight loss, was Hedges' g= 0.31 (95% CI 0.04 to 0.58) favoring CBT and for cognitive factors was g = 0.37 (95% CI 0.22 to 0.45). Results indicated a significant association between motivation outcomes ESs (slope= 0.992, 95% CI 0.13 to 1.85, p =0.02) and selfefficacy ESs (slope= 1.59, 95% CI 0.24 to 2.94, p =0.02) and weight outcomes.

Discussion: Current evidence suggests that CBT is effective in weight loss. Clinicians will be more effective if they add to their weight loss interventions components for increasing the motivation and self-efficacy of their patients.