title: New interdisciplinary cognitive-behavioural-nutritional approach to obesity treatment: a 5-year follow-up study.
abstract: OBJECTIVE
  The aim of this prospective case-control study was to assess the long-term effectiveness of interdisciplinary cognitive-behavioural-nutritional therapy, combined with daily physical exercise and relaxation sessions, on weight and psychosocial issues during a 6-week in-hospital stay.
  
  
  METHODS
  Five years (60 +/- 1 months) later, the patients were readmitted for a one-day medical evaluation including a physical examination and laboratory work-up, and the completion of a detailed questionnaire focusing on dietary and psychosocial factors that may affect weight loss/regain.
  
  
  METHODS
  The follow-up population consisted of 55 morbidly obese subjects aged 49.5 +/- 2 years (45 females and 10 males; BMI: 40 +/- 0.7 kg/m2). During their initial 6-week in-hospital stay, they lost an average of 7.6 +/- 0.4 kg.
  
  
  RESULTS
  Five years later, 25.5% of the patients had lost a further 11.9 +/- 1.8 kg, 20% maintained their initial weight loss (0.6 +/- 0.4 kg), and 54.5% regained weight (10.4 +/- 1 kg). The weight changes significant correlated with the degree of psychosocial difficulties (p < 0.001), eating behaviour problems (p < 0.001), dietary fat intake (p < 0.005) and total energy intake (p < 0.05). Fasting plasma insulin and blood glucose concentrations were significantly higher in the patients who regained weight after five years, and significantly lower in those who had lost more weight.
  
  
  CONCLUSIONS
  As a whole, these results show the efficacy of an interdisciplinary approach to the long-term treatment of morbidly obese patients. It is likely that an outpatient psychological follow-up would have improved this therapeutic success.
authors.affiliation: Division of Therapeutic Education for Chronic Diseases, Geneva University Hospital, Switzerland. Alain.Golay@hcuge.ch
authors.forename: A
authors.initials: A
authors.lastname: Golay
authors.forename: S
authors.initials: S
authors.lastname: Buclin
authors.forename: J
authors.initials: J
authors.lastname: Ybarra
authors.forename: F
authors.initials: F
authors.lastname: Toti
authors.forename: C
authors.initials: C
authors.lastname: Pichard
authors.forename: N
authors.initials: N
authors.lastname: Picco
authors.forename: N
authors.initials: N
authors.lastname: de Tonnac
authors.forename: A F
authors.initials: AF
authors.lastname: Allaz
mesh_terms: D015992:Body Mass Index; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000534:rehabilitation / Q000628:therapy*; D010348:Patient Care Team; D011446:Prospective Studies; D012064:Relaxation Therapy