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Personalized cognitive-behavioural therapy for obesity (CBT-OB): theory, strategies and procedures
BioPsychoSocial Medicine ( IF 2.3 ) Pub Date : 2020-03-09 , DOI: 10.1186/s13030-020-00177-9
Riccardo Dalle Grave , Massimiliano Sartirana , Simona Calugi

Personalized cognitive-behavioural therapy for obesity (CBT-OB) is a new treatment that combines the traditional procedures of standard behavioural therapy for obesity (i.e., self-monitoring, goal setting, stimulus control, contingency management, behavioural substitution, skills for increasing social support, problem solving and relapse prevention) with a battery of specific cognitive strategies and procedures. These enable the treatment to be individualized, and to help patients to address the cognitive processes that previous research has found to be associated with treatment discontinuation, the amount of weight lost and long-term weight-loss maintenance. The treatment programme can be delivered at three levels of care, outpatient, day hospital and residential, and includes six modules, which are introduced according to the individual patient’s needs as part of a flexible, personalized approach. The primary goals of CBT-OB are to help patients to (i) achieve, accept and maintain healthy weight loss; (ii) adopt a lifestyle conducive to weight control; and (iii) develop a stable “weight-control mindset”. A randomized controlled trial has found that 88 patients suffering from morbid obesity treated with CBT-OB followed a period of residential treatment achieved a mean weight loss of 15% after 12 months, with no tendency to regain weight between 6 and 12 months. The treatment efficacy is also supported by data from a study assessing the effects of group CBT-OB delivered in a real-world clinical setting. In that study, 77 patients with morbid obesity who completed the treatment achieved 9.9% weight loss after 18 months. These promising results, if confirmed by future clinical studies, suggest that CBT-OB has the potential to be more effective than traditional weight-loss lifestyle-modification programmes.

中文翻译:

肥胖的个性化认知行为疗法(CBT-OB):理论,策略和程序

肥胖症的个性化认知行为疗法(CBT-OB)是一种新疗法,结合了肥胖症标准行为疗法的传统程序(即自我监测,目标设定,刺激控制,应急管理,行为替代,提高社交能力的技术)支持,解决问题和预防复发)以及一系列特定的认知策略和程序。这些可以使治疗个体化,并帮助患者应对先前的研究发现与停止治疗,体重减轻和长期减肥保持相关的认知过程。该治疗计划可在门诊,日间医院和住院三个护理级别进行,包括六个模块,作为灵活,个性化方法的一部分,将根据患者的需求进行介绍。CBT-OB的主要目标是帮助患者(i)达到,接受并维持健康的减肥;(ii)采取有利于控制体重的生活方式;(iii)建立稳定的“控制体重的心态”。一项随机对照试验发现,接受CBT-OB治疗的88例病态肥胖患者在接受一定时期的住院治疗后,在12个月后平均体重减轻了15%,并且在6到12个月内没有恢复体重的趋势。一项评估在现实世界中临床环境中递送的CBT-OB组疗效的研究数据也支持了治疗功效。在该研究中,完成治疗的77名病态肥胖患者在18个月后体重减轻了9.9%。
更新日期:2020-03-09
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