title: Cognitive-behavioral treatment reduces attrition in treatment-resistant obese women: results from a 6-month nested case-control study.
abstract: OBJECTIVE
  The aim of this nested case-control study was to compare the effectiveness of cognitive-behavioral treatment (CBT) for treatment-resistant obese (body mass index [BMI] ≥ 30 kg/m²) women compared with standard dietary treatment. The main outcome measures were attrition and weight loss success.
  
  
  METHODS
  We designed a 6-month case-control study, nested within a cohort of adult (age ≥ 18 years) treatment-resistant (history of at least two previous diet attempts) obese women. Cases were 20 women who were offered CBT sessions. Controls (n=39) were randomly selected from the source population and matched to cases in terms of baseline age, BMI, and number of previous diet attempts.
  
  
  RESULTS
  Compared with controls, cases were significantly more likely to complete the 6-month program in both age-adjusted (odds ratio [OR]=2.94, 95% confidence interval [CI]=1.05-8.97) and multivariate-adjusted (OR=2.77, 95% CI=1.02-8.34) analyses. In contrast, cases were not more likely to achieve weight loss success in age-adjusted (OR=1.32, 95% CI=0.86-1.67) and multivariate-adjusted (OR=1.21, 95% CI=0.91-1.44) analyses.
  
  
  CONCLUSIONS
  Compared with a standard dietary treatment, CBT was significantly more effective in reducing attrition in treatment-resistant obese women, without differences in terms of weight loss success.
authors.affiliation: Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Via Bassi, 21, I-27100, Pavia, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Tagliabue
authors.affiliation: Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Via Bassi, 21, I-27100, Pavia, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Repossi
authors.affiliation: Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Via Bassi, 21, I-27100, Pavia, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Trentani
authors.affiliation: Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Via Bassi, 21, I-27100, Pavia, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ferraris
authors.affiliation: Psychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi, 21, I-27100, Pavia, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Martinelli
authors.affiliation: "Studi Cognitivi", Post-graduate Cognitive Psychotherapy School, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Vinai
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D004035:Diet Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000628:therapy*; D010349:Patient Compliance; D016896:Treatment Outcome; D015431:Weight Loss