Effects of cognitive behavioural therapy targeting eating behaviour (CBT-TEB) : a novel obesity treatment
Author: Stahre, Lisbeth
Date: 2017-02-24
Location: Centrum för psykiatriforskning, plan 6, Lokal: ”36-salen”, Norra Stationsgatan 69, Stockholm
Time: 13.00
Department: Inst för klinisk neurovetenskap / Dept of Clinical Neuroscience
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Thesis (1.191Mb)
Abstract
Objective: The overall objective was to evaluate the outcome of the 10-week (20/30 h) CBTTEB treatment programme for persons with obesity. The evaluation took place in three studies.
Paper I (Study I): Method. One hundred and five obese women from an obesity unit`s waiting list participated in a randomised controlled study. Of these, 62 took part in the CBT-TEB programme and 43 served as controls. Follow-up was 6-,12- and 18-months post-treatment, without any booster treatment. Results. Weight change for the CBT-TEB patients after therapy was -8.5 kg (SD 16.1) (per-protocol). Weight change at the follow-up for the CBT-TEB patients 18 months after the end of therapy was -10.4 kg (SD 10.8) (per-protocol) and -5.7 kg (SD 9.5) (ITT). Weight change (per-protocol) for the controls at the 18-month follow-up was + 2.3 kg (SD 7.0) and +1.6 kg (SD 6.0) (ITT). About two thirds still fulfilled the widely held success criterion of having lost 5% or more of initial weight at 1.5 years after the end of therapy.
Paper II (Study II): Method. Fifty-four obese women from a child care centre participated in a randomised controlled trial involving the CBT-TEB programme and a conventional weight loss programme. Of these, 16 women took part in the CBT-TEB programme and 26 in the control programme. Follow-up was 6-,12- and 18-months post-treatment, without any booster treatment. Results. Weight change for the CBT-TEB patients after therapy was -8.6 kg (SD 2.9) (per-protocol) and -7.7 kg (SD 3.8) (ITT). Weight change for the CBT-TEB patients 18 months after the end of therapy was –5.9 kg (SD 5.4) (per-protocol) and -5.5 kg (SD 5.5) (ITT). Weight change for the participants in the control programme after the end of therapy was -0.7 kg (SD 1.2) (per-protocol) and -1.4 kg (SD 1.6) (ITT). Weight change for the participants in the control programme at follow-up 18 months after end of therapy was +0.3 kg (SD 4.3) (per-protocol) and -0.6 kg (SD 5.5) (ITT).
Paper III (Study III): Method. Eighty-three primary care patients (74 females and nine males) started the CBT-TEB programme. Follow-up was at 6 months. An objective in this study was also to evaluate change in waist circumference (WC) and waist-to-hip ratio (WHR) after therapy. Eating behaviour was determined by the Three Factor Eating Questionnaire and obesity-related problems by the Obesity-Related Problems Scale. Results. Weight change (ITT) for the CBTTEB patients after therapy was -4.5 kg (SD 3.9), and at 6 months -4.4 kg (SD 4.9). Emotional and uncontrolled eating decreased and cognitive control increased during therapy. Obesity-related problems decreased.
Conclusions: The results demonstrate a very satisfactory efficacy for the CBT-TEB programme. It was feasible to implement the programme in primary healthcare, using ordinary personnel as group leaders after a short period of training.
Paper I (Study I): Method. One hundred and five obese women from an obesity unit`s waiting list participated in a randomised controlled study. Of these, 62 took part in the CBT-TEB programme and 43 served as controls. Follow-up was 6-,12- and 18-months post-treatment, without any booster treatment. Results. Weight change for the CBT-TEB patients after therapy was -8.5 kg (SD 16.1) (per-protocol). Weight change at the follow-up for the CBT-TEB patients 18 months after the end of therapy was -10.4 kg (SD 10.8) (per-protocol) and -5.7 kg (SD 9.5) (ITT). Weight change (per-protocol) for the controls at the 18-month follow-up was + 2.3 kg (SD 7.0) and +1.6 kg (SD 6.0) (ITT). About two thirds still fulfilled the widely held success criterion of having lost 5% or more of initial weight at 1.5 years after the end of therapy.
Paper II (Study II): Method. Fifty-four obese women from a child care centre participated in a randomised controlled trial involving the CBT-TEB programme and a conventional weight loss programme. Of these, 16 women took part in the CBT-TEB programme and 26 in the control programme. Follow-up was 6-,12- and 18-months post-treatment, without any booster treatment. Results. Weight change for the CBT-TEB patients after therapy was -8.6 kg (SD 2.9) (per-protocol) and -7.7 kg (SD 3.8) (ITT). Weight change for the CBT-TEB patients 18 months after the end of therapy was –5.9 kg (SD 5.4) (per-protocol) and -5.5 kg (SD 5.5) (ITT). Weight change for the participants in the control programme after the end of therapy was -0.7 kg (SD 1.2) (per-protocol) and -1.4 kg (SD 1.6) (ITT). Weight change for the participants in the control programme at follow-up 18 months after end of therapy was +0.3 kg (SD 4.3) (per-protocol) and -0.6 kg (SD 5.5) (ITT).
Paper III (Study III): Method. Eighty-three primary care patients (74 females and nine males) started the CBT-TEB programme. Follow-up was at 6 months. An objective in this study was also to evaluate change in waist circumference (WC) and waist-to-hip ratio (WHR) after therapy. Eating behaviour was determined by the Three Factor Eating Questionnaire and obesity-related problems by the Obesity-Related Problems Scale. Results. Weight change (ITT) for the CBTTEB patients after therapy was -4.5 kg (SD 3.9), and at 6 months -4.4 kg (SD 4.9). Emotional and uncontrolled eating decreased and cognitive control increased during therapy. Obesity-related problems decreased.
Conclusions: The results demonstrate a very satisfactory efficacy for the CBT-TEB programme. It was feasible to implement the programme in primary healthcare, using ordinary personnel as group leaders after a short period of training.
List of papers:
I. Stahre L, Hällström, T. A short-term cognitive group treatment program gives substantial weight reduction up to 18 months from the end of treatment:a randomized controlled trial. Eat Weight Disord. 2005 Mar;10(1):51-8.
Pubmed
II. Stahre L, Tärnell B, Håkanson CE, Hällström T. A randomized controlled trial of two weight-reducing short-term group treatment programs for obesity with an 18-month follow-up. Int J Behav Med. 2007;14(1):48-55.
Pubmed
III. Stahre L, Blomstrand A, Hällström T. Observational study on implementation and effectiveness of Cognitive Behavioural Therapy Targeting Eating Behaviour for patients with abdominal obesity in an ordinary primary health care setting. [Manuscript]
I. Stahre L, Hällström, T. A short-term cognitive group treatment program gives substantial weight reduction up to 18 months from the end of treatment:a randomized controlled trial. Eat Weight Disord. 2005 Mar;10(1):51-8.
Pubmed
II. Stahre L, Tärnell B, Håkanson CE, Hällström T. A randomized controlled trial of two weight-reducing short-term group treatment programs for obesity with an 18-month follow-up. Int J Behav Med. 2007;14(1):48-55.
Pubmed
III. Stahre L, Blomstrand A, Hällström T. Observational study on implementation and effectiveness of Cognitive Behavioural Therapy Targeting Eating Behaviour for patients with abdominal obesity in an ordinary primary health care setting. [Manuscript]
Institution: Karolinska Institutet
Supervisor: Hällström, Tore
Issue date: 2017-01-02
Rights:
Publication year: 2016
ISBN: 978-91-7676-521-0
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