Objective: Individuals with obesity show executive dysfunctions that have been implicated in weight management failure. Initial evidence suggests that cognitive remediation therapy (CRT) conducted after behavioral weight loss (BWL) treatment improves weight loss and executive function, but efficacy for CRT conducted before BWL treatment is unknown. This study investigated whether group CRT in adults with Class II or III obesity (body mass index, BMI≥35 kg/m2) improves weight loss, executive function, weight management behavior, and mental and physical health in real-world group BWL treatment. Method: In this prospective single-center, assessor-blind trial (DRKS00009333), 270 adults with Class II and III obesity (age 44.5 ± 12.8 years, BMI 45.6 ± 6.9 kg/m2, and 68.9% women) were randomized to CRT with 8 group sessions over 2 months versus no treatment control, followed by routine BWL treatment of up to 12 months for both groups. The primary outcome was percent weight change at 6 months. Secondary outcomes included executive functions, weight management behaviors, and mental and physical health. Results: In intent-to-treat analyses, overall weight loss after 6 months was 1.2%, 95% CI [-2.0% to -0.4%], p = .002. The difference between arms was 0.4%, 95% CI [-1.1% to 1.8%], p = .629, Cohen's d = 0.09, after 6 months and 0.3%, 95% CI [-1.5% to 2.2%], p = .721, Cohen's d = 0.01, after 12 months. Improvements in most secondary outcomes including executive functions were seen at most time points, however, without differences between arms. Conclusions: Group CRT versus no treatment prior to real-world BWL treatment in adults with Class II and III obesity does not improve weight loss. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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重度肥胖成人行为减肥治疗前的集体认知矫正治疗：一项随机临床试验（CRT 研究）。

目标：肥胖个体表现出与体重管理失败有关的执行功能障碍。初步证据表明，在行为减肥 (BWL) 治疗后进行认知矫正治疗 (CRT) 可改善体重减轻和执行功能，但在 BWL 治疗前进行 CRT 的疗效尚不清楚。本研究调查了 II 级或 III 级肥胖（体重指数，BMI ≥ 35 kg/m2）成人的 CRT 是否能改善真实世界 BWL 治疗中的体重减轻、执行功能、体重管理行为以及身心健康。方法：在这项前瞻性单中心、评估者盲法试验 (DRKS00009333) 中，270 名 II 级和 III 级肥胖成人（年龄 44.5 ± 12.8 岁，BMI 45.6 ± 6.9 kg/m2，和 68. 9% 的女性）被随机分配到 CRT 组，在 2 个月内进行 8 组疗程，而没有治疗对照，然后两组进行长达 12 个月的常规 BWL 治疗。主要结果是 6 个月时的体重变化百分比。次要结果包括执行功能、体重管理行为以及身心健康。结果：在意向治疗分析中，6 个月后总体体重减轻为 1.2%，95% CI [-2.0% 至 -0.4%]，p = .002。两组之间的差异为 0.4%, 95% CI [-1.1% 至 1.8%], p = .629, Cohen's d = 0.09, 6 个月后和 0.3%, 95% CI [-1.5% 至 2.2%], p = .721，Cohen 的 d = 0.01，12 个月后。在大多数时间点，包括执行功能在内的大多数次要结果都有改善，但两组之间没有差异。结论：对 II 级和 III 级肥胖成人进行真实世界 BWL 治疗之前，组 CRT 与未治疗相比，并不能改善体重减轻。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。