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Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives

Authors Castelnuovo G, Pietrabissa G, Manzoni GM, Cattivelli R, Rossi A, Novelli M, Varallo G, Molinari E

Received 8 February 2017

Accepted for publication 30 April 2017

Published 6 June 2017 Volume 2017:10 Pages 165—173

DOI https://doi.org/10.2147/PRBM.S113278

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Professor Igor Elman


Gianluca Castelnuovo,1,2 Giada Pietrabissa,1,2 Gian Mauro Manzoni,1,3 Roberto Cattivelli,1,2 Alessandro Rossi,1 Margherita Novelli,1 Giorgia Varallo,1 Enrico Molinari1,2

1Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, 2Department of Psychology, Catholic University of Milan, Milan, 3Faculty of Psychology, eCampus University, Novedrate, Italy

Abstract: Obesity is a chronic condition associated with risk factors for many medical ­complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways. Evidence-based strategies to improve weight loss, maintain a healthy weight, and reduce related comorbidities typically integrate different interventions: dietetic, nutritional, physical, behavioral, psychological, and if necessary, pharmacological and surgical ones. Such treatments are implemented in a multidisciplinary context with a clinical team composed of endocrinologists, nutritionists, dietitians, physiotherapists, psychiatrists, psychologists, and sometimes surgeons. Cognitive behavioral therapy (CBT) is traditionally recognized as the best established treatment for binge eating disorder and the most preferred intervention for obesity, and could be considered as the first-line treatment among psychological approaches, especially in a long-term perspective; however, it does not necessarily produce a successful weight loss. Traditional CBT for weight loss and other protocols, such as enhanced CBT, enhanced focused CBT, behavioral weight loss treatment, therapeutic education, acceptance and commitment therapy, and sequential binge, are discussed in this review. The issue of long-term weight management of obesity, the real challenge in outpatient settings and in lifestyle modification, is discussed taking into account the possible contribution of mHealth and the stepped-care approach in health care.

Keywords: overweight, BED, ACT, BWL, BWLT, mHealth, virtual reality, chronic care management, stepped care
 

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