Cognitive behavioral group therapy ineffective for weight maintenance in type 2 diabetes
CBGT consisted of 17 group sessions led by a trained psychologist targeting dysfunctional thinking regarding lifestyle, weight, body perception, and relapse.
Results from a study conducted in The Netherlands showed that cognitive behavioral group therapy (CBGT) did not prevent overweight and obese patients with type 2 diabetes from regaining weight lost during weight loss programs over 2 years.
The Prevention of Weight Regain (POWER) trial was a single-center, parallel-group, randomized controlled trial conducted from March 2010 to May 2015. The trial recruited 206 patients with type 2 diabetes and a body mass index (BMI) of 27 kg/m2 or greater from an outpatient diabetes clinic at a university hospital.
Patients were started on a very low-calorie diet, and 158 participants who achieved a 5% or greater weight loss after 8 weeks of dieting were included in the trial. Patients were then randomly assigned to the CBGT intervention or a control group, which received usual care consisting of regular scheduled visits to the treating internist and diabetes nurse. Those in the CBGT group received usual care plus CBGT, which consisted of 17 group sessions led by a trained psychologist, targeting dysfunctional thinking regarding lifestyle, weight, body perception, and relapse.
The primary outcomes were the between-group differences in body weight at 2 years and weight regain from randomization to 2 years of follow-up. Secondary outcomes included several cardiovascular risk factors (HbA1c level, insulin dose, and lipid levels) and psychological well-being (depression and anxiety).
At 2 years, there was no significant between-group difference in body weight (-1.2 kg) and the between-group difference in weight regain was -0.7, also not significant. Likewise, there were no significant differences found for cardiovascular risk factors or psychological well-being.
The findings of this study demonstrate that CBGT plus usual care provides no additional benefit for prevention of weight regain or improvement in cardiovascular risk factors or psychological well-being compared with usual care alone.
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: European Association for the Study of Diabetes (EASD) 2017 Annual Meeting; September 11-15, 2017; Lisbon, Portugal. Abstract 606.