Cognitive behavioural therapy for obesity (CBT-OB) is a treatment that was originally designed for outpatient management of patients on a one-to-one basis. Since then, however, it has now been adapted to be administered to groups and in intensive rehabilitation units. This means that the treatment may now be delivered in several care “steps” in different settings, according to the needs of the individual patient. All CBT-OB steps associate dietary and physical activity recommendations with specific cognitive behavioural procedures, which enable further individualisation of treatment. These procedures were conceived on the basis of previous research indicating associations between cognitive processes and important factors such as treatment adherence, the amount of weight lost, and long-term weight-loss maintenance. Thus CBT-OB acts to help the patients not only to reach, accept and maintain a healthy weight loss, adopting a lifestyle centred on weight control, but also to develop a stable “weight-control mindset”. Promising results from a recent randomised controlled trial have already shown that patients suffering from morbid obesity (who are generally excluded from trials due to the high incidence of comorbidities) achieved a mean weight loss of 15% after 12 months of CBT-OB treatment. Even more encouragingly, participants showed no tendency to regain weight between months 6 and 12. Although longer-term outcome data is not yet available, it is worth mentioning that a similar treatment has been proven an effective means of managing obesity associated with binge-eating disorder (BED) over time.
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