Type 2 Diabetes Weight Regain Not Prevented With Group CBT
Study results show no scientific justification behind offering CBGT alongside usual care for patients with T2D who have lost weight.
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Cognitive behavioral group therapy (CBGT) after weight loss did not prevent weight regain in patients with type 2 diabetes (T2D), nor did it improve psychological well-being or cardiovascular risk factors, according to findings presented at the 53rd European Association for the Study of Diabetes (EASD) Annual Meeting, held September 11-15 in Lisbon, Portugal.
Weight loss programs tend to be ineffective in the long term because patients with T2D who follow them often regain the weight they lost. Researchers at the Erasmus Medical Center in Rotterdam, The Netherlands, sought to determine whether CBGT sessions would be effective in preventing weight regain or improving psychological well-being and cardiovascular risk factors.
Researchers selected 206 patients with T2D and a BMI greater than 27 kg/m2 to begin a very low-calorie diet as a part of randomized, controlled Prevention of Weight Regain (POWER) study (Netherlands Trial Register identification NTR2264). After 8 weeks of dieting, 158 participants who lost more than 5% of body weight were selected to participate in the intervention. The control group received usual care, which included regularly scheduled appointments to the treating internist and diabetes nurse, and the treatment group received CBGT alongside usual care. The CBGT group received 17 psychologist-led sessions, intended to restructure dysfunctional cognitions related to weight, body perception, lifestyle, and relapse.
At 2 years, the between-group body weight difference was -1.2 kg (95% CI, -7.7 to 5.3; P =.717); weight regain difference was -0.7 kg (95% CI, -3.1 to 1.6; P =.556).
There was no difference in the secondary outcomes, which evaluated psychological well-being by assessing depression, anxiety, self-esteem, quality of life, eating disorders, fatigue, and physical activity, and evaluated cardiovascular risk factors by measuring HbA1C, insulin dose, and lipid level.
“CGBT after diet-induced weight loss did not prevent weight regain or improve cardiovascular risk factors or psychological wellbeing,” the researchers concluded. “Our results provide no scientific justification to offer CBGT on top of usual care.”
Berk KAC, Buijks H, Verhoeven AJM, et al. Cognitive behavioural group therapy to prevent weight regain in type 2 diabetes: a randomised controlled trial. Presented at: 53rd European Association for the Study of Diabetes Annual Meeting; September 11-15, 2017; Lisbon, Portugal. Abstract 606.