Cognitive behavioural therapy for obesity: one-year follow-up in a clinical setting.
Cognitive behavioural therapy (CBT) is the most comprehensive means of medically treating obesity, but only few data have so far been published concerning its long-term effectiveness. We here report our experience of 1068 consecutive patients (868 females) treated with CBT at a university-based obesity centre. The patients were enrolled into three different programmes: a 14-week LEARN programme (672 patients), a 16-week MOB programme for the morbidly obese (259 patients), or a 20-week BINGE programme for subjects affected by binge eating (137 patients). Eighty-five percent of the subjects completed the weekly programmes. The percentage of patients attending the scheduled control visits during the 1-year follow-up gradually decreased, being very low in the BINGE group (10%). The percentage weight loss was an average of 6% during the weekly courses, being higher in the MOB programme; by the end of the weekly sessions, it exceeded 10% of initial body weight in 22% of cases and increased to 36% during the follow-up. The cumulative probability of follow-up was higher among the patients undergoing the MOB and LEARN programmes than among the BINGE patients (p < 0.0001), and decreased with the increasing severity of obesity. Female gender and a weight loss of > 10% i.b.w. increased compliance to follow-up. The study further demonstrates the difficulty of achieving compliance to chronic management of obesity and the critical role of binge eating disorder in the medium-term treatment of obesity. Strategies are needed to improve adherence to a follow-up protocol.
Melchionda
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Servizio di Malattie del Metabolismo e Disturbi del Comportamento Alimentare, Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Italy.
Besteghi
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L
Di Domizio
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S
Pasqui
F
F
Nuccitelli
C
C
Migliorini
S
S
Baraldi
L
L
Natale
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S
Manini
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R
Bellini
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M
Belsito
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C
Forlani
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G
Marchesini
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D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D002032:Bulimia / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic; D011340:Problem Solving; D015397:Program Evaluation; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss