Personalized Group Cognitive Behavioural Therapy for Obesity: a Longitudinal Study in a Real-world Clinical Setting

Overview

Journal Eat Weight Disord

Publisher Springer

Date 2018 Oct 12

PMID 30306498

Citations 9

Authors

Riccardo Dalle Grave

Simona Calugi

Giovanna Bosco

Luigi Valerio

Chiara Valenti

Marwan El Ghoch

Dante Zini

Affiliations

Soon will be listed here.

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/m) 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.

Citing Articles

The impact of weight loss interventions on disordered eating symptoms in people with overweight and obesity: a systematic review & meta-analysis.

Tsompanaki E, Koutoukidis D, Wren G, Tong H, Theodoulou A, Wang D EClinicalMedicine. 2025; 80:103049.

PMID: 39981343 PMC: 11841075. DOI: 10.1016/j.eclinm.2024.103049.

Weight Loss Programs: Why Do They Fail? A Multidimensional Approach for Obesity Management.

Khattab R Curr Nutr Rep. 2024; 13(3):478-499.

PMID: 38861120 DOI: 10.1007/s13668-024-00551-x.

Dropout in cognitive behavioral treatment in adults living with overweight and obesity: a systematic review.

Lopes Neri L, Mariotti F, Guglielmetti M, Fiorini S, Tagliabue A, Ferraris C Front Nutr. 2024; 11:1250683.

PMID: 38784136 PMC: 11111870. DOI: 10.3389/fnut.2024.1250683.

Cognitive behavioral therapy for managing obesity in patients with chronic kidney disease: Study protocol for a randomized controlled trial.

Kurnik Mesaric K, Kodric J, Zakrajsek B, Marn Pernat A, Bogataj S, Pajek J Contemp Clin Trials Commun. 2023; 36:101236.

PMID: 38074489 PMC: 10709099. DOI: 10.1016/j.conctc.2023.101236.

Applying psycho-behavioural phenotyping in obesity characterization.

Camacho-Barcia L, Lucas I, Miranda-Olivos R, Jimenez-Murcia S, Fernandez-Aranda F Rev Endocr Metab Disord. 2023; 24(5):871-883.

PMID: 37261609 PMC: 10492697. DOI: 10.1007/s11154-023-09810-8.

References

Forman E, Butryn M, Manasse S, Crosby R, Goldstein S, Wyckoff E . Acceptance-based versus standard behavioral treatment for obesity: Results from the mind your health randomized controlled trial. Obesity (Silver Spring). 2016; 24(10):2050-6. PMC: 5051349. DOI: 10.1002/oby.21601. View

Dalle Grave R, Calugi S, Marchesini G . The influence of cognitive factors in the treatment of obesity: Lessons from the QUOVADIS study. Behav Res Ther. 2014; 63:157-61. DOI: 10.1016/j.brat.2014.10.004. View

Fitzpatrick S, Jeffery R, Johnson K, Roche C, Van Dorsten B, Gee M . Baseline predictors of missed visits in the Look AHEAD study. Obesity (Silver Spring). 2013; 22(1):131-40. PMC: 3943994. DOI: 10.1002/oby.20613. View

McGuire M, Wing R, Klem M, Hill J . Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res. 1999; 7(4):334-41. DOI: 10.1002/j.1550-8528.1999.tb00416.x. View

Franz M, Boucher J, Rutten-Ramos S, VanWormer J . Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet. 2015; 115(9):1447-63. DOI: 10.1016/j.jand.2015.02.031. View

Jacob A, Moullec G, Lavoie K, Laurin C, Cowan T, Tisshaw C . Impact of cognitive-behavioral interventions on weight loss and psychological outcomes: A meta-analysis. Health Psychol. 2018; 37(5):417-432. DOI: 10.1037/hea0000576. View

Peterson C, Crosby R, Wonderlich S, Joiner T, Crow S, Mitchell J . Psychometric properties of the eating disorder examination-questionnaire: factor structure and internal consistency. Int J Eat Disord. 2007; 40(4):386-9. DOI: 10.1002/eat.20373. View

Reas D, Grilo C, Masheb R . Reliability of the Eating Disorder Examination-Questionnaire in patients with binge eating disorder. Behav Res Ther. 2005; 44(1):43-51. DOI: 10.1016/j.brat.2005.01.004. View

Perri M, Sears Jr S, Clark J . Strategies for improving maintenance of weight loss. Toward a continuous care model of obesity management. Diabetes Care. 1993; 16(1):200-9. DOI: 10.2337/diacare.16.1.200. View

10.

Mannucci E, Ricca V, Barciulli E, di Bernardo M, Travaglini R, Cabras P . Quality of life and overweight: the obesity related well-being (Orwell 97) questionnaire. Addict Behav. 1999; 24(3):345-57. DOI: 10.1016/s0306-4603(98)00055-0. View

11.

Carels R, Cacciapaglia H, Douglass O, Rydin S, OBrien W . The early identification of poor treatment outcome in a women's weight loss program. Eat Behav. 2004; 4(3):265-82. DOI: 10.1016/S1471-0153(03)00029-1. View

12.

Mond J, Hay P, Rodgers B, Owen C, Beumont P . Temporal stability of the Eating Disorder Examination Questionnaire. Int J Eat Disord. 2004; 36(2):195-203. DOI: 10.1002/eat.20017. View

13.

Christian J, Tsai A, Bessesen D . Interpreting weight losses from lifestyle modification trials: using categorical data. Int J Obes (Lond). 2009; 34(1):207-9. PMC: 2897147. DOI: 10.1038/ijo.2009.213. View

14.

Fairburn C, Beglin S . Assessment of eating disorders: interview or self-report questionnaire?. Int J Eat Disord. 1994; 16(4):363-70. View

15.

Melchionda N, Marchesini G, Apolone G, Cuzzolaro M, Mannucci E, Grossi E . The QUOVADIS Study: features of obese Italian patients seeking treatment at specialist centers. Diabetes Nutr Metab. 2003; 16(2):115-24. View

16.

Wang Y, Gorenstein C . Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Braz J Psychiatry. 2014; 35(4):416-31. DOI: 10.1590/1516-4446-2012-1048. View

17.

Calugi S, Milanese C, Sartirana M, El Ghoch M, Sartori F, Geccherle E . The Eating Disorder Examination Questionnaire: reliability and validity of the Italian version. Eat Weight Disord. 2016; 22(3):509-514. DOI: 10.1007/s40519-016-0276-6. View

18.

Wadden T, Butryn M, Wilson C . Lifestyle modification for the management of obesity. Gastroenterology. 2007; 132(6):2226-38. DOI: 10.1053/j.gastro.2007.03.051. View

19.

Dalle Grave R, Calugi S, El Ghoch M . Lifestyle modification in the management of obesity: achievements and challenges. Eat Weight Disord. 2013; 18(4):339-49. DOI: 10.1007/s40519-013-0049-4. View

20.

Dalle Grave R, Calugi S, Molinari E, Petroni M, Bondi M, Compare A . Weight loss expectations in obese patients and treatment attrition: an observational multicenter study. Obes Res. 2005; 13(11):1961-9. DOI: 10.1038/oby.2005.241. View