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

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.

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Correspondence to Riccardo Dalle Grave.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Dalle Grave, R., Calugi, S., Bosco, G. et al. Personalized group cognitive behavioural therapy for obesity: a longitudinal study in a real-world clinical setting. Eat Weight Disord 25, 337–346 (2020). https://doi.org/10.1007/s40519-018-0593-z

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Keywords

  • Obesity
  • Lifestyle modification
  • Cognitive behavioural therapy
  • Group therapy
  • Weight loss
  • Weight maintenance
  • Attrition