Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives

Abstract

Obesity is a chronic condition associated with risk factors for many medical complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways. Evidence-based strategies to improve weight loss, maintain a healthy weight, and reduce related comorbidities typically integrate different interventions: dietetic, nutritional, physical, behavioral, psychological, and if necessary, pharmacological and surgical ones. Such treatments are implemented in a multidisciplinary context with a clinical team composed of endocrinologists, nutritionists, dietitians, physiotherapists, psychiatrists, psychologists, and sometimes surgeons. Cognitive behavioral therapy (CBT) is traditionally recognized as the best established treatment for binge eating disorder and the most preferred intervention for obesity, and could be considered as the first-line treatment among psychological approaches, especially in a long-term perspective; however, it does not necessarily produce a successful weight loss. Traditional CBT for weight loss and other protocols, such as enhanced CBT, enhanced focused CBT, behavioral weight loss treatment, therapeutic education, acceptance and commitment therapy, and sequential binge, are discussed in this review. The issue of long-term weight management of obesity, the real challenge in outpatient settings and in lifestyle modification, is discussed taking into account the possible contribution of mHealth and the stepped-care approach in health care.

Long-Term Outcomes of Group-Based Treatment for Obese Children and Adolescents

“…Psychotherapy could coach patients in positive-behavior development, weightloss goal setting, weight-loss maintenance, and problem coping. 14 In our study, 17 (39.5%) participants decreased or maintained %W/H (successful group) while 26 (60.5%) increased %W/H (failed group). The exercise frequency and duration were higher for the successful than the failed group.…”

Cognitive-Behavioral Therapy: Current Paths in the Management of Obesity

“…CBT appears less effective when BED is in association with obesity, especially in long-term weight loss maintenance [1]. Since obesity has a multifactorial etiology, the best intervention approach seems to be an integrated treatment made up of nutritional intervention, physical reconditioning program, and cognitive-behavioral psychotherapy [1]. Moreover, in interventions, specifically intended for childhood obesity, family, and peer background must be taken into account in order to promote a long-term weight loss maintenance [38], since they play a key role in shaping and supporting healthy-habits.…”

“…Developing new and better treatment for obesity and its related chronic clinical complications is one of the major challenge that world healthcare systems are facing today, both from a clinical and economic perspective [1]. It is well known that obesity is a worldwide chronic disease, whose treatment is complicated by its interaction with other chronic illnesses or chronic disorders [2].…”

“…dysfunctional feeding and lack of proper physical activity [1]. This interpretation of the phenomenon seems, however, extremely reductive, greatly simplifying a much more complex Cognitive Behavioral Therapy and Clinical Applicationsreality.…”

“…Several studies have tested the efficacy of CBT in reducing binge behavior frequency [38]. CBT appears less effective when BED is in association with obesity, especially in long-term weight loss maintenance [1]. Since obesity has a multifactorial etiology, the best intervention approach seems to be an integrated treatment made up of nutritional intervention, physical reconditioning program, and cognitive-behavioral psychotherapy [1].…”