Dalle Grave Riccardo, Sartirana Massimiliano, El Ghoch Marwan, Calugi Simona
Department of Eating and Weight Disorders, Villa Garda Hospital, Verona, Italy.
Diabetes Metab Syndr Obes. 2017 Jun 1;10:195-206. doi: 10.2147/DMSO.S139496. eCollection 2017.
Multistep cognitive behavioral therapy for obesity (CBT-OB) is a treatment that may be delivered at three levels of care (outpatient, day hospital, and residential). In a stepped-care approach, CBT-OB associates the traditional procedures of weight-loss lifestyle modification, ie, physical activity and dietary recommendations, with specific cognitive behavioral strategies that have been indicated by recent research to influence weight loss and maintenance by addressing specific cognitive processes. The treatment program as a whole is delivered in six modules. These are introduced according to the individual patient's needs in a flexible and personalized fashion. A recent randomized controlled trial has found that 88 patients suffering from morbid obesity treated with multistep residential CBT-OB achieved a mean weight loss of 15% after 12 months, with no tendency to regain weight between months 6 and 12. The treatment has also shown promising long-term results in the management of obesity associated with binge-eating disorder. If these encouraging findings are confirmed by the two ongoing outpatient studies (one delivered individually and one in a group setting), this will provide evidence-based support for the potential of multistep CBT-OB to provide a more effective alternative to standard weight-loss lifestyle-modification programs.
肥胖症的多步骤认知行为疗法（CBT-OB）是一种可在三个护理级别（门诊、日间医院和住院）实施的治疗方法。在逐步护理方法中，CBT-OB将减肥生活方式改变的传统程序，即体育活动和饮食建议，与近期研究表明通过解决特定认知过程来影响体重减轻和维持的特定认知行为策略相结合。整个治疗方案分为六个模块。这些模块根据个体患者的需求以灵活和个性化的方式引入。最近一项随机对照试验发现，88名接受多步骤住院CBT-OB治疗的病态肥胖患者在12个月后平均体重减轻了15%，在第6个月至第12个月期间没有体重反弹的趋势。该治疗方法在与暴饮暴食症相关的肥胖症管理方面也显示出了有前景的长期效果。如果这两项正在进行的门诊研究（一项是个体治疗，一项是团体治疗）证实了这些令人鼓舞的发现，这将为多步骤CBT-OB有可能提供比标准减肥生活方式改变方案更有效的替代方案提供循证支持。
