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Comparative Effectiveness of Cognitive Behavioral Therapy and Behavioral Therapy in Obesity: A Systematic Review and Network Meta-Analysis

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Abstract

We aimed to evaluate the effects of obesity treatment with behavioral therapy (BT) and cognitive behavioral therapy (CBT) interventions compared with multiple comparators and find effective techniques or combinations of techniques in BT and CBT interventions for weight loss. We systematically searched electronic databases and selected randomized controlled trials using CBT or BT intervention for obesity treatment in overweight adults or adults with obesity without psychological symptoms. Both pairwise meta-analysis and network meta-analysis were performed to comprehensively evaluate the comparative effects between interventions. We classified the techniques used in BT and CBT interventions and compared the treatment effects between techniques. Compared with no treatment as a common comparator, CBT was most effective for weight loss, followed by BT, usual care (UC), and minimal care (MC). CBT was a more effective intervention than BT, but the effect of CBT compared to BT was not remarkable in network estimates. The most used BT techniques were feedback and monitoring, and the most used CBT technique was cognitive restructuring. Our results indicated that CBT and BT are effective interventions for weight loss, and that successful weight loss requires more aggressive interventions such as BT or CBT than MC and UC.

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Data Availability

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2021R1F1A1052227).

Author information

Author notes

  1. Jin-Young Cha and Seo-Young Kim have contributed equally to this work for first authorship.

Authors and Affiliations

  1. Nubebe Obesity Research Institute, Seoul, South Korea

    Jin-Young Cha, Seo-Young Kim & Young-Woo Lim

  2. Nubebe Korean Medical Clinic (Incheon Center), Incheon, South Korea

    Seo-Young Kim

  3. Nubebe Korean Medical Clinic (Bundang Center), Seongnam, South Korea

    Young-Woo Lim

  4. Nubebe Korean Medical Clinic (Hongdae Center), Seoul, South Korea

    Ka-Hye Choi

  5. Graduate School of Education, Dongguk University, 30, Pildong-ro 1 gil, Jung-gu, Seoul, 04620, South Korea

    In-Soo Shin

Authors
  1. Jin-Young Cha
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  2. Seo-Young Kim
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  3. Young-Woo Lim
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  4. Ka-Hye Choi
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  5. In-Soo Shin
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Contributions

JYC and SYK reviewed literature and wrote the manuscript as equally contributing authors with support from YWL and KHC. ISS verified the analytical methods. All authors discussed the results and approved the final manuscript.

Corresponding author

Correspondence to In-Soo Shin.

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Authors Jin-Young Cha, Seo-Young Kim, Young-Woo Lim, Ka-Hye Choi, and In-Soo Shin declare that they have no conflict of interest.

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Cha, JY., Kim, SY., Lim, YW. et al. Comparative Effectiveness of Cognitive Behavioral Therapy and Behavioral Therapy in Obesity: A Systematic Review and Network Meta-Analysis. J Clin Psychol Med Settings (2024). https://doi.org/10.1007/s10880-023-10000-6

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