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Cognitive behavioural therapy for obesity: One-year follow-up in a clinical setting

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Abstract

Cognitive behavioural therapy (CBT) is the most comprehensive means of medically treating obesity, but only few data have so far been published concerning its long-term effectiveness. We here report our experience of 1068 consecutive patients (868 females) treated with CBT at a university-based obesity centre. The patients were enrolled into three different programmes: a 14-week LEARN programme (672 patients), a 16-week MOB programme for the morbidly obese (259 patients), or a 20-week BINGE programme for subjects affected by binge eating (137 patients). Eighty-five percent of the subjects completed the weekly programmes. The percentage of patients attending the scheduled control visits during the 1-year follow-up gradually decreased, being very low in the BINGE group (10%). The percentage weight loss was an average of 6% during the weekly courses, being higher in the MOB programme; by the end of the weekly sessions, it exceeded 10% of initial body weight in 22% of cases and increased to 36% during the follow-up. The cumulative probability of follow-up was higher among the patients undergoing the MOB and LEARN programmes than among the BINGE patients (p<0.0001), and decreased with the increasing severity of obesity. Female gender and a weight loss of >10% i.b.w. increased compliance to follow-up. The study further demonstrates the difficulty of achieving compliance to chronic management of obesity and the critical role of binge eating disorder in the medium-term treatment of obesity. Strategies are needed to improve adherence to a follow-up protocol.

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Authors and Affiliations

  1. Servizio di Malattie del Metabolismo e Disturbi del Comportamento Alimentare, Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Azienda Ospedaliera S.Orsola-Malpighi, Via Massarenti 9, 40138, Bologna, Italy

    N. Melchionda, L. Besteghi, S. Di Domizio, F. Pasqui, C. Nuccitelli, S. Migliorini, L. Baraldi, S. Natale, R. Manini &  G. Marchesini

  2. Dipartimento di Psichiatria, Università di Bologna, Italy

    M. Bellini, C. Belsito & G. Forlani

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  1. N. Melchionda
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  2. L. Besteghi
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  3. S. Di Domizio
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  4. F. Pasqui
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  5. C. Nuccitelli
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  6. S. Migliorini
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  7. L. Baraldi
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  8. S. Natale
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  9. R. Manini
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  10. M. Bellini
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  11. C. Belsito
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  12. G. Forlani
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  13. G. Marchesini
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Correspondence to G. Marchesini.

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Melchionda, N., Besteghi, L., Di Domizio, S. et al. Cognitive behavioural therapy for obesity: One-year follow-up in a clinical setting. Eat Weight Disord 8, 188–193 (2003). https://doi.org/10.1007/BF03325012

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