Cha Jin-Young, Kim Seo-Young, Lim Young-Woo, Choi Ka-Hye, Shin In-Soo
Nubebe Obesity Research Institute, Seoul, South Korea.
Nubebe Korean Medical Clinic (Incheon Center), Incheon, South Korea.
J Clin Psychol Med Settings. 2025 Mar;32(1):96-110. doi: 10.1007/s10880-023-10000-6. Epub 2024 Jan 29.
We aimed to evaluate the effects of obesity treatment with behavioral therapy (BT) and cognitive behavioral therapy (CBT) interventions compared with multiple comparators and find effective techniques or combinations of techniques in BT and CBT interventions for weight loss. We systematically searched electronic databases and selected randomized controlled trials using CBT or BT intervention for obesity treatment in overweight adults or adults with obesity without psychological symptoms. Both pairwise meta-analysis and network meta-analysis were performed to comprehensively evaluate the comparative effects between interventions. We classified the techniques used in BT and CBT interventions and compared the treatment effects between techniques. Compared with no treatment as a common comparator, CBT was most effective for weight loss, followed by BT, usual care (UC), and minimal care (MC). CBT was a more effective intervention than BT, but the effect of CBT compared to BT was not remarkable in network estimates. The most used BT techniques were feedback and monitoring, and the most used CBT technique was cognitive restructuring. Our results indicated that CBT and BT are effective interventions for weight loss, and that successful weight loss requires more aggressive interventions such as BT or CBT than MC and UC.
我们旨在评估行为疗法（BT）和认知行为疗法（CBT）干预措施用于肥胖治疗时，与多种对照措施相比的效果，并找出BT和CBT干预措施中有助于减肥的有效技术或技术组合。我们系统检索了电子数据库，并选择了针对超重成年人或无心理症状的肥胖成年人使用CBT或BT干预进行肥胖治疗的随机对照试验。进行了成对荟萃分析和网状荟萃分析，以全面评估各干预措施之间的比较效果。我们对BT和CBT干预中使用的技术进行了分类，并比较了不同技术之间的治疗效果。与作为常见对照的不治疗相比，CBT对减肥最有效，其次是BT、常规护理（UC）和最低限度护理（MC）。CBT是比BT更有效的干预措施，但在网状估计中，CBT与BT相比的效果并不显著。BT最常用的技术是反馈和监测，CBT最常用的技术是认知重构。我们的结果表明，CBT和BT是有效的减肥干预措施，而且成功减肥需要比MC和UC更积极的干预措施，如BT或CBT。
