Effects of cognitive behavioral therapy on weight maintenance after successful weight loss in women; a randomized clinical trial

Weight regain after weight loss is a main challenge in obesity management. Cognitive behavioral therapy (CBT) has been introduced as an option for achieving weight loss but not tested for weight maintenance. The aim of this study was to evaluate the effects of CBT on weight maintenance after successful weight loss.

Female adults [n = 113, BMI = 23-30 kg/m²; age = 18-45 years], who had lost at least 10% of their body weight by using a weight loss program, were randomly allocated to either CBT or control group for a further 24-week weight-maintenance period.

Compared with control group, CBT treatment improved weight loss maintenance (mean difference, -2.2 kg [95% CI, -3.50, -0.94]; P = 0.001), BMI (mean difference, -0.77 kg/m²; [95% CI, -1.25, -0.28]; P = 0.002), and waist circumference (mean difference, -2.08 cm; [95% CI, -3.31, -0.844]; P = 0.001) at the end of the 24-week period intervention. Estimated energy intake showed a significant reduction over time in CBT group, while it increased in control group (P < 0.001). There was also a significant group × time interaction for mean daily steps over the 24-week period with CBT having a higher level (P < 0.001). However, changes in lipid profiles and carbohydrate metabolism were not significantly different between the groups.

Cognitive behavioral therapy is an effective tool for weight maintenance over a 24-week period in successful weight losers, with corresponding maintenance of a reduced energy intake and doing more physical activity which may helpful for weight maintenance in the long term.