Nutrition Counseling

NC: Weight Management (2007-2008)

Read more about behavior change theory.

Cognitive-Behavioral Therapy

  • Weight management
  • Intervention
    What is the evidence that cognitive-behavioral therapy of short-term duration (< six months) for weight loss, results in health/food behavior change in adults counseled in an outpatient/clinic setting?
    • Conclusion

      Two small positive-quality RCTs provide evidence that short-term (10-week) cognitive-behavioral therapy is an effective method of overweight and obesity treatment.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the evidence that cognitive behavioral therapy of intermediate duration (six to 12 months) for weight loss results in health or food behavior change in adults counseled in an outpatient or clinic setting?
    • Conclusion

      One neutral-quality six-month randomized controlled trial (86 obese adults) provides evidence that intermediate-duration (six to 12 months) behavioral therapy and behavioral therapy combined with a personalized system of skill-acquisition targeting weight loss is more effective than weight-loss education alone in facilitating weight loss, decreasing both total energy intake and percentage of calories from fat and increasing physical activity.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the evidence that cognitive-behavioral therapy of long-term duration (>12 months) for weight loss, results in health/food behavior change in adults counseled in an outpatient/clinic setting?
    • Conclusion

      Two positive randomized controlled trials (65 participants received behavior therapy and a very-low-calorie diet) and one neutral quasi-experimental study (84 participants received behavior therapy) evaluated behavior therapy as a component of a weight-loss program of long-term duration (at least 12 months). Behavior therapy was not always the variable of randomization. Participants receiving behavior therapy lost weight at the conclusion of treatments. Upon follow-up, there was some weight regain, but participants remained at a lower weight than baseline. Studies that included a very-low-calorie diet (VLCD) to initiate rapid initial weight-loss, combined with behavior therapy, also appeared to produce long-term weight loss. [Note: This is not a statement recommending VLCDs or suggesting that VLCDs are more beneficial than low-calorie diets.]

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.