Director, Medical and Mind Weight Loss Camberwell, VIC, and; Obesity Medical Practitioner, Epworth HealthCare, Melbourne, VIC, and; Honorary Research Fellow, Department of Psychiatry, St Vincent's Hospital, The University of Melbourne, Melbourne, VIC, Australia.
Senior Research Fellow, Department of Psychiatry, St Vincent's Hospital and Academic Unit for Psychiatry of Old Age, The University of Melbourne, Melbourne, VIC, and; Psychiatrist, Medical and Mind Weight Loss, Camberwell, VIC, and St Vincent's Hospital, Melbourne, Melbourne, VIC, and; Epworth HealthCare, Melbourne, VIC, Australia.
Australas Psychiatry. 2020 Apr;28(2):140-147. doi: 10.1177/1039856219871882. Epub 2019 Sep 16.
Obesity is a global pandemic with psychological, physical and metabolic consequences including in people with mental health conditions. Anti-obesity medications (AOMs) are available to treat obesity and can produce clinically meaningful weight loss but do not address associated psychological issues. We evaluated the usefulness and acceptability of an adjunct online cognitive behavioural therapy (CBT) programme for improving psychological outcomes.
We conducted a real-world 26-week observational study of 120 adults attending an obesity clinic who undertook a comprehensive weight management programme that included standard diet and exercise interventions, an AOM and an online 10-module CBT intervention. Baseline and 26-week psychological, metabolic and physical measures were compared.
At 26 weeks, depression, anxiety, stress and emotional eating levels for the sample decreased significantly compared to baseline (all < .01). Satisfaction and acceptability were highly rated. The mean weight loss was 8.13 ± 3.83%. Mean waist circumference reduction was 7.62 ± 3.4 cm.
Online CBT has the potential to be a useful adjunct to AOMs and lifestyle interventions for providing psychological support as shown by improvement in mental health, emotional eating and acceptability scales. This warrants further investigation through a randomised controlled trail.
肥胖是一种全球性的流行疾病，对心理健康状况不佳的人群来说，其具有心理、生理和代谢等方面的后果。目前已有抗肥胖药物（AOM）用于治疗肥胖症，并能产生临床意义上的体重减轻，但无法解决相关的心理问题。我们评估了一种辅助性在线认知行为疗法（CBT）方案在改善心理结果方面的实用性和可接受性。
我们对参加肥胖症诊所的 120 名成年人进行了一项为期 26 周的真实世界观察性研究，他们接受了综合体重管理计划，其中包括标准饮食和运动干预、AOM 和在线的 10 个模块的 CBT 干预。比较了基线和 26 周的心理、代谢和身体测量结果。
与基线相比，26 周时该样本的抑郁、焦虑、压力和情绪化进食水平显著降低（均 <.01）。满意度和可接受性评价很高。平均体重减轻 8.13 ± 3.83%。平均腰围减少 7.62 ± 3.4 厘米。
在线 CBT 有可能成为 AOM 和生活方式干预的有用辅助手段，为心理健康、情绪化进食和可接受性评分的改善提供心理支持。这需要通过随机对照试验进一步研究。
