Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, VR, Italy.
Graduate School in Nutrition, University of Modena and Reggio Emilia, Modena, Italy.
Eat Weight Disord. 2020 Apr;25(2):337-346. doi: 10.1007/s40519-018-0593-z. Epub 2018 Oct 10.
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.
Sixty-seven adult patients with obesity (body mass index (BMI) ≥ 30 kg/m) 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).
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.
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 III, longitudinal cohort study.
重度肥胖症难以治疗，且非手术治疗缺乏有力证据支持。本研究旨在探讨一种新的治疗方法，即“个性化”团体认知行为治疗肥胖症（CBT-OB）的即时和长期效果，这种新方法旨在针对先前研究中与脱落、减重和体重维持相关的特定认知过程。
从意大利国家卫生服务肥胖症诊所连续转介的 67 名肥胖成年患者（体重指数（BMI）≥30 kg/m²）入组。每位患者均接受 22 节团体 CBT-OB 课程（6 个月减重阶段 14 节，随后 12 个月体重维持阶段 8 节）。
76.2%的患者完成了治疗，6 个月后平均减重 11.5%（意向治疗分析中为 10%），18 个月后平均减重 9.9%（意向治疗分析中为 7.5%）。减重与心血管危险因素、焦虑、抑郁和饮食障碍精神病理学的显著减少以及肥胖相关生活质量的改善相关。
这些发现为在标准临床环境中使用 CBT-OB 治疗肥胖症提供了强有力的初步支持，并证明其在随机对照试验中进一步评估的合理性。
三级，纵向队列研究。
