一项针对成人肥胖的认知矫正治疗的随机对照试验。

A randomised controlled trial of manualized cognitive remediation therapy in adult obesity.

机构信息

School of Medicine & Centre for Health Research, Western Sydney University, Locked Bag 1747, Penrith 2751, Australia; Graduate School of Health, University Technology Sydney, NSW, Australia.

School of Medicine & Centre for Health Research, Western Sydney University, Locked Bag 1747, Penrith 2751, Australia.

出版信息

Appetite. 2018 Apr 1;123:269-279. doi: 10.1016/j.appet.2017.12.023. Epub 2017 Dec 24.

DOI:10.1016/j.appet.2017.12.023

PMID:29278718

Abstract

OBJECTIVE

Research has indicated that individuals with obesity have neurocognitive deficits, especially in cognitive flexibility that may in turn impact on their weight loss and maintenance. Consequently, we examined the efficacy of a manualised face-to-face cognitive remediation therapy for obesity (CRT-O) within a randomised controlled trial, in terms of improving cognitive flexibility, reducing binge eating behaviour, improving quality of life and helping with weight loss.

METHODS

80 adults with obesity (body mass index >30 kg/m), 70% binge eaters, received three weekly sessions of group Behavioural Weight Loss (BWL) and then were randomised to 8 sessions of individual CRT-O or to a no-treatment control group.

RESULTS

Mixed-effects model analyses revealed that the CRT-O group had a significant improvement in their cognitive flexibility at post-treatment and 3-month follow-up compared to the control group (Cohen's d = 0.96 to 2.1). 68% of those in the CRT-O group achieved a weight loss of 5% or more at follow-up compared to only 15% of the controls (Cohen's d = 1.3). Changes in set-shifting predicted changes in weight (p < .05). Binge eating reduced in the CRT-O group compared to the control (Cohen's d = 0.80).

DISCUSSION

This is the first study showing the efficacy of CRT-O for obesity. Future CRT-O studies with longer follow-ups and pairing it with longer BWL programs are needed.

TRIALS REGISTRY (ANZCTR): 12613000537752.

DATE OF ANZCTR REGISTRATION

14 May 2013.

摘要

目的

研究表明，肥胖个体存在神经认知缺陷，尤其是在认知灵活性方面，这可能反过来影响他们的减肥和维持。因此，我们在一项随机对照试验中，检查了一种基于手册的面对面肥胖认知矫正治疗（CRT-O）的疗效，以改善认知灵活性、减少暴食行为、提高生活质量和帮助减肥。

方法

80 名肥胖成年人（BMI>30kg/m2），70%为暴食者，接受每周三次的小组行为体重减轻（BWL）治疗，然后随机分为 8 次个体 CRT-O 或无治疗对照组。

结果

混合效应模型分析显示，与对照组相比，CRT-O 组在治疗后和 3 个月随访时的认知灵活性有显著改善（Cohen's d=0.96 至 2.1）。在随访时，68%的 CRT-O 组体重减轻了 5%或更多，而对照组只有 15%（Cohen's d=1.3）。转变的预测对体重的变化（p<0.05）。与对照组相比，暴食行为在 CRT-O 组减少（Cohen's d=0.80）。