CT for Obesity

I'm not a specialist in this area but I did a quick literature search and found some references that you may find helpful:

Cooper, Zafra; Fairburn, Christopher G. (2002) A new cognitive behavioural approach to the treatment of obesity. Behaviour Research & Therapy, 39, 499-511. ABSTRACT - While behavioural approaches to the management of obesity are often successful in achieving clinically significant weight loss, the weight lost is generally regained. The great majority of patients return to their pre-treatment weight within 3 yrs. There have been attempts to improve the long-term effectiveness of behavioural treatment but the results have been disappointing. In this paper we suggest that, among other factors, this is because of the neglect of the contribution of cognitive factors to weight regain, and because there is often ambiguity over the goals of treatment. The authors present a cognitive behavioural analysis of the processes involved in weight regain, and describe a new cognitive behavioural treatment derived from it. This treatment is designed to minimise the problem of weight regain by addressing psychological obstacles to the acquisition of, and long-term adherence to, effective weight-control behaviour.

Marchesini, G.; Natale, S.; Chierici, S.; Manini, R.; Besteghi, L.; Di Domizio, S.; Sartini, A.; Pasqui, F.; Baraldi, L.; Forlani, G.; Melchionda, N. (2002). Effects of cognitive-behavioural therapy on health-related quality of life in obese subjects with and without binge eating disorder. International Journal of Obesity & Related Metabolic Disorders, 26.) 1261-1267. ABSTRACT - Examined the effects of cognitive-behavioral therapy (CBT) on health-related quality of life (HRQL) in obese individuals. 168 obese adults (aged 18-67 yrs), some diagnosed with binge eating disorder, completed 12 weekly sessions of weight-control related CBT. Subsequently, Ss completed questionnaires concerned emotional mental health, social functioning, severity of binge eating, and symptoms of psychopathological distress. Ss also completed interviews with psychologists and underwent physical examinations. Results show that 4.3% of Ss reported that their health status had improved during the previous year, 46.7% reported their health as stable, and 48.9% perceived that their health worsened. 50% of Ss were classified as having binge eating disorder (BED). Ss receiving CBT lost an average of 9.4 kg. HRQL improved in all treated Ss, although improvement by BED Ss was less than others.

Leibbrand, R.; Fichter, M. M. (2002) Maintenance of weight loss after obesity treatment: Is continuous support necessary? Behaviour Research & Therapy, 40, 1275-128 ABSTRACT - Examined outcome differences of 109 obese subjects, who participated in a 10-week cognitive-behavioral inpatient treatment followed by either a weight maintenance program or a followup period without professional support. Self-rated weight loss, eating behaviors, and general psychopathology were assessed several months before treatment, when subjects were admitted, at discharge, and at the 6-, 12-, and 18-month follow-ups. Structured interviews for mental disorders and eating pathology were conducted additionally. The mean weight of the sample at baseline was 127 kg. Weight loss of the total sample amounted to 8.0 kg (6.3%) and was completely maintained during the follow-up period. Significant reductions of eating and general psychopathology were observed at the 18-month follow-up. The outcome in the maintenance condition did not significantly differ from the outcome in the control condition. Weight regain after obesity treatment is not inevitable, but continuous patient-therapist contacts do not distinctly improve treatment effects.

Niero, Mauro; Martin, Mona; Finger, Thomas; Lucas, Ramona; Mear, Isabelle; Wild, Diane; Glauda, Laura; Patrick, Donald L. (2002). A new approach to multicultural item generation in the development of two obesity-specific measures: The Obesity and Weight Loss Quality of Life (OWLQOL) Questionnaire and the Weight-Related Symptom Measure (WRSM). Clinical Therapeutics: The International Peer-Reviewed Journal of Drug Therapy, 24, 690-700. ABSTRACT - Existing obesity-specific instruments have shortcomings with respect to cross-cultural input, application to differing levels of severity, conceptual clarity, and patient burden. This study aimed to develop culturally sensitive measures of quality of life and symptoms in overweight or obese persons, both those trying and not trying to lose weight. Currently accepted criteria and guidelines for questionnaire development were streamlined and augmented to include cross-cultural input from 5 European countries and the US. The preliminary pool of items was created based on interviews conducted in the US with 68 overweight 28-70 yr olds, followed by a check of item translatability and preharmonization across all languages. 10 additional qualitative in-country interviews were then conducted to produce further culture-specific items, followed by forward and backward translations, plus cognitive debriefing interviews in each country. Finally, an expanded international meeting was held to ensure inclusion of appropriate new items and their acceptability across all 6 cultures. These procedures resulted in development of the 41-item Obesity and Weight Loss Quality of Life questionnaire and the 20-item Weight-Related Symptom Measure. These questionnaires need further psychometric validation.

Bacon, L.; Keim, N. L.; Van Loan, M. D.; Derricote, M.; Gale, B.; Kazaks, A.; Stern, J. S. (2002) Evaluating a "non-diet' wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors. International Journal of Obesity & Related Metabolic Disorders, 26, 854-865. ABSTRACT - Evaluated the effects of a health-centered non-diet wellness program and compared the program to a traditional weight loss-centered diet program for 78 free-living, obese, Caucasian, female, 30-45 yr old chronic dieters. Six months of weekly group intervention in a non-diet wellness program or a traditional diet program was followed by 6 mo of monthly after-care group support. Outcome measures included weight, body mass index, metabolic fitness (BP, blood lipids), energy expenditure, eating behavior (restraint, eating disorder pathology), psychological well being (self-esteem, depression, body image), attrition and attendance, and S evaluations of treatment helpfulness. Measures were obtained at baseline, 3 mo, 6 mo and 1 yr. Results (1 yr) show that cognitive restraint increased in the diet group and decreased in the non-diet group. Both groups demonstrated significant improvement in many metabolic fitness, psychological and eating behavior variables. There was high attrition in the diet group (41%), compared to 8% in the non-diet group. Weight significantly decreased in the diet group, while there was no significant change in the non-diet group.

Kern, Lee S.; Friedman, Kelli E.; Reichmann, Simona K.; Costanzo, Philip R.; Musante, Gerard J. (2002). Changing eating behavior: A preliminary study to consider broader measures of weight control treatment success. Eating Behaviors, 3, 113-12. ABSTRACT - Evaluated changes in the self-reported obesity-inducing problematic eating behaviors (EBs; snacking, binge eating, portion sizes, and meal skipping) of 52 obese adults (33 women and 19 men) attending a residential weight loss facility on 2 consecutive occasions (mean time lapse between initial and return visits 130.4 days for the men and 140.8 days for the women). Three questions were addressed: (1) what types of EBs are associated with excessive caloric consumption, (2) can these EBs be changed over the course of a cognitive-behavioral weight loss program, and (3) does the focus on changing EBs provide a set of useful and appropriate non-weight based outcome measures for estimating treatment success in diet-seeking clients? For each of the EBs studied, Ss reported engaging in the behavior significantly less frequently at the time of their return visit. It is proposed that changes in EBs provide a useful and appropriate nonweight based outcome measure for estimating treatment success in diet-seeking clients.

Pendleton, Victor R.; Goodrick, G. Ken; Poston, Walker S. Carlos; Reeves, Rebecca S.; Foreyt, John P. (2002) Exercise augments the effects of cognitive-behavioral therapy in the treatment of binge eating. International Journal of Eating Disorders, 31, 172-184. ABSTRACT - This study evaluated the effects of adding exercise and maintenance to cognitive-behavior therapy (CBT) for binge eating disorder (BED) in obese women. 114 obese female binge eaters (aged 20-64 yrs) were randomized into 4 groups: CBT with exercise and maintenance, CBT with exercise, CBT with maintenance, and CBT only. 84 women completed the 16-mo study. It was found that Ss who received CBT with exercise experienced significant reductions in binge eating frequency compared with Ss who received CBT only. The CBT with exercise and maintenance group had a 58% abstinence rate at the end of the study period and an average reduction of 2.2 body mass index (BMI) units (approximately 14 lb). BMI was significantly reduced in the Ss in both the exercise and maintenance conditions. The results suggest that adding exercise to CBT, and extending the duration of treatment, enhances outcome and contributes to reductions in binge eating and BMI.

Oginska-Bulik, Nina; Juczynski, Zygfryd (2001). Coping with stress as a determinant of reducing overweight in women. Studia Psychologica, 43, 23-31. ABSTRACT - The purpose of the study was to investigate whether coping with stress and other psychological variables contribute to the prediction of reducing overweight in women, and to compare the level of these predictors before and after a program of reducing overweight based on psychological actions. 70 overweight women, 35-55 yrs old, were examined twice, before and after the weight reducing program. The program used a behavioral-cognitive approach and was based on the premises that increasing women's personal resources such as self-efficacy beliefs, self-esteem, level of optimism, and enhancing skills for coping with stress all may help them to reduce overweight. Outcome was measured with: Stress Perceived Scale, Generalized Self-Efficacy Scale, Rosenberg's Self-Esteem Scale, Life Orientation Test, Multidimensional Health Locus of Control Scale, Coping Inventory for Stressful Situations, State-Trait Personality and Kuhl's Action Control Scale. Results reveal that coping with stress is a determinant of reducing overweight in women, task and avoidance oriented strategies, in particular. Perceiving stress, self-efficacy beliefs and level of optimism also were predictors of reducing excessive weight in women.

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