Nutrition Counseling

NC: Maintenance of Health/Behavior Change Following Short-term CBT (2008)

• Intervention
  What is the evidence that cognitive-behavioral therapy of short-term duration (less than six months) targeted to weight management results in long-term maintenance of health or food behavior change in adults counseled in an outpatient or clinic setting?

  • Conclusion

    One positive quality meta-analysis (29 RCTs), four neutral quality RCTs and three observational studies (one positive, one neutral, one negative quality) provide strong evidence that weight management treatment with diet and cognitive-behavioral therapy given in a six-month initial intervention period, results in modest weight loss after follow-up of at least 18 months post-treatment. Attrition rates increased the longer the follow-up was conducted. This is a common weakness of these studies that may result in outcome bias.

  • 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.
  • Evidence Summary: Long-Term Maintenance Following Short-Term Treatment
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Anderson JW, Vichitbandra S, Qian W, Kryscio RJ. Long-term weight maintenance after an intensive weight-loss program. J Am Coll Nutr. 1999 Dec; 18 (6): 620-627.
      • Anderson JW, Konz EC, Frederich RC, Wood CL. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr. 2001 Nov; 74 (5): 579-584.
      • Holden JH, Darga LL, Olson SM, Stettner DC, Ardito EA, Lucas CP. Long-term follow-up of patients attending a combination very-low calorie diet and behaviour therapy weight loss programme. Int J Obes Relat Metab Disord. 1992 Aug; 16 (8): 605-613.
      • Kramer FM, Jeffery RW, Forster JL, Snell MK. Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women. Int J Obes. 1989; 13 (2): 123-136.
      • Miura J, Arai K, Tsukahara S, Ohno M, Ikeda Y. The long-term effectiveness of combined therapy by behavior modification and very low calorie diet: Two years follow-up. Int J Obes. 1989; 13 Suppl 2: 73-77.
      • Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, Sardinha LB, Lohman TG.  Pre-treatment predictors of attrition and successful weight managaement in women. International Journal of Obesity and Related Metabolic DIsorders, 2004; 28: 1,124-1,133.
  • Search Plan and Results: NC: Long-term maintenance of short-term tx 2008