Brief cognitive-behavioral therapy for weight loss in midlife women: a controlled study with follow-up

Figures & data

Table 1 Participant characterization

Variables	CBT group n = 11	Control group (WL) n = 10
Marital status
Married or in a relationship	7	9
Not married or in a relationship	4	1
Professional status
Active	9	8
Inactive	2	2
Educational level
Primary school	2	1
Middle school	3	2
High school	2	4
University	4	3
Family annual income
Less than 10,000 euro	4	0
10,001–20,000 euro	2	3
20,001–37,500 euro	4	3
37,501–70,000 euro	1	3
More than 70,001 euro	0	1
Menopausal status
Premenopause	3	2
Perimenopause	4	4
Postmenopause	4	4
Physical exercise
Yes	4	3
No	7	7

Abbreviations: CBT, cognitive-behavioral therapy; WL, waiting list.

Figure 1 Progress of participants through the study.

Table 2 Contents of each session

Session	Contents
1st	Relationship with the food and the body Eating routines Psycho-education about the consequences of excessive weight and obesity Motivation increment
2nd	Analysis of situations when there was an excessive ingestion of food Exploration of thoughts, emotions, and behaviors subsequent to excessive food ingestion Evaluation of perceived control before and during excessive food ingestion
3rd	The ABC model Lifestyle characteristics facilitating excessive eating Trigger identification
4th	Trigger identification and exploration of obstacles to trigger management Cognitive restructuring Behavioral techniques Physical exercise promotion
5th	Evaluation of successful and unsuccessful implementation of behavioral techniques Exploration of new behavioral techniques Development of mindfulness Development of attention towards triggers and consequent behavior (successful versus unsuccessful management) Motivation increment
6th	Assessment of successful and unsuccessful management of excessive food ingestion Difficulty anticipation Assessment of cognitive and behavioral techniques
7th	Lifestyle: integrating changes Redefinition of daily well-being
8th	Maintenance of adaptive changes made Relapse prevention

Abbreviation: ABC, activating event, beliefs, consequences.

Table 3 Comparison of participants placed in intervention (CBT) with participants in waiting list (WL) at baseline assessment (T1)

Variables	Student’s t-test t (df) P
Weight (kg)	−1.061 (16) ns
Abdominal perimeter (cm)	−1.014 (16) ns
BMI (kg/m^2)	−1.850 (16) ns
Health QoL	0.324 (16) ns
Sexual QoL	−0.579 (16) ns
Depression	−0.463 (16) ns
Anxiety	0.474 (16) ns
Stress	0.542 (16) ns
Restrained eating	−0.857 (16) ns
Emotional eating	−0.548 (16) ns
External eating	0.117 (16) ns

Abbreviations: BMI, body mass index; CBT, cognitive-behavioral therapy; ns, not significant; QoL, quality of life.

Table 4 Waiting list: T1, T2, and T3 assessment for all variables

Variables	T1 n = 10 M (SD)	T2 n = 9 M (SD)	T3 n = 9 M (SD)	I	J	Mean difference I–J (SE) P
Weight (kg)	78.1 (7.2)	78.1 (6.3)	78.9 (5.7)	T1	T2	0.022 (0.561) ns
					T3	−0.822 (0.765) ns
				T2	T3	−0.844 (0.492) ns
Abdominal perimeter (cm)	98.5 (7.0)	99.5 (7.0)	99.0 (5.8)	T1	T2	−0.989 (1.508) ns
					T3	−0.478 (0.695) ns
				T2	T3	0.511 (1.289) ns
BMI (kg/m^2)	31.8 (2.4)	31.8 (2.2)	32.2 (2.2)	T1	T2	−0.011 (0.234) ns
					T3	−0.372 (0.332) ns
				T2	T3	−0.361 (0.212) ns
Health QoL	2.5 (0.6)	2.7 (0.7)	2.8 (0.6)	T1	T2	−0.175 (0.138) ns
					T3	−0.286 (0.124) ns
				T2	T3	−0.111 (0.109) ns
Sexual QoL	3.3 (0.7)	3.1 (1.0)	3.1 (0.9)	T1	T2	0.222 (0.229) ns
					T3	0.222 (0.176) ns
				T2	T3	0.000 (0.157) ns
Depression	1.7 (0.8)	1.6 (0.6)	1.7 (0.8)	T1	T2	0.079 (0.107) ns
					T3	0.016 (0.230) ns
				T2	T3	−0.063 (0.235) ns
Anxiety	1.6 (0.6)	1.5 (0.6)	1.4 (0.4)	T1	T2	0.063 (0.093) ns
					T3	0.206 (0.137) ns
				T2	T3	0.143 (0.141) ns
Stress	1.9 (0.5)	1.8 (0.9)	1.9 (0.8)	T1	T2	0.079 (0.160) ns
					T3	−0.016 (0.198) ns
				T2	T3	−0.095 (0.245) ns
Restrained eating	3.0 (0.7)	2.8 (0.8)	2.7 (0.7)	T1	T2	0.178 (0.262) ns
					T3	0.278 (0.262) ns
				T2	T3	0.100 (0.130) ns
Emotional eating	2.7 (0.8)	3.0 (1.0)	2.8 (0.9)	T1	T2	−0.222 (0.121) ns
					T3	−0.093 (0.146) ns
				T2	T3	0.130 (0.161) ns
External eating	2.8 (0.4)	2.8 (0.6)	2.9 (0.7)	T1	T2	−0.033 (0.125) ns
					T3	−0.167 (0.166) ns
				T2	T3	−0.133 (0.147) ns

Abbreviations: BMI, body mass index; ns, not significant; QoL, quality of life; T1, baseline; T2, posttreatment; T3, follow-up.

Table 5 CBT: T1, T2 and T3 assessment for all variables

Variables	T1 n = 11 M (SD)	T2 n = 9 M (SD)	T3 n = 7 M (SD)	I	J	Mean difference I-J (SE) P
Weight (kg)	76.9 (5.4)	76.4 (5.1)	74.5 (4.4)	T1	T2	−1.414 (1.367) ns
					T3	1.643 (0.719)*
				T2	T3	3.057 (1.446)*
Abdominal perimeter (cm)	96.5 (5.9)	96.1 (5.5)	95.0 (6.0)	T1	T2	−1.143 (1.716) ns
					T3	1.171 (1.917) ns
				T2	T3	2.314 (1.133)*
BMI (kg/m^2)	30.9 (2.3)	30.7 (2.6)	29.9 (2.1)	T1	T2	−0.594 (0.574) ns
					T3	0.654 (0.283)*
				T2	T3	1.249 (0.650) ns
Health QoL	2.7 (0.6)	3.0 (0.5)	2.9 (0.6)	T1	T2	−0.347 (0.213) ns
					T3	−0.490 (0.243)*
				T2	T3	−0.143 (0.125) ns
Sexual QoL	3.0 (1.0)	3.1 (1.0)	3.2 (0.5)	T1	T2	−0.190 (0.160) ns
					T3	−0.190 (0.377) ns
				T2	T3	0.000 (0.291) ns
Depression	1.6 (0.7)	1.3 (0.3)	1.5 (0.6)	T1	T2	0.184 (0.145) ns
					T3	−0.020 (0.248) ns
				T2	T3	−0.204 (0.184) ns
Anxiety	1.6 (0.7)	1.4 (0.4)	1.5 (0.5)	T1	T2	0.150 (0.152) ns
					T3	0.027 (0.201) ns
				T2	T3	−0.122 (0.154) ns
Stress	2.0 (0.6)	1.6 (0.3)	1.9 (0.6)	T1	T2	0.245 (0.138) ns
					T3	0.095 (0.137) ns
				T2	T3	−0.245 (0.206) ns
Restrained eating	2.8 (0.7)	3.3 (0.6)	3.3 (0.6)	T1	T2	−0.486 (0.307) ns
					T3	−0.586 (0.248)*
				T2	T3	−0.100 (0.251) ns
Emotional eating	2.8 (0.7)	2.4 (0.7)	2.6 (0.7)	T1	T2	0.264 (0.274) ns
					T3	0.385 (0.315) ns
				T2	T3	0.121 (0.203) ns
External eating	2.9 (0.6)	2.7 (0.4)	2.7 (0.4)	T1	T2	0.143 (0.139) ns
					T3	0.371 (0.143)**
				T2	T3	0.229 (0.081)**

Notes:

* P < 0.10;

** P < 0.05.

Abbreviations: BMI, body mass index; CBT, cognitive-behavioral therapy; ns, not significant; QoL, quality of life; T1, baseline; T2, posttreatment; T3, follow-up.