한방비만학회지 (Journal of Korean Medicine for Obesity Research)

  • 제20권2호
  • /
  • Pages.178-192
  • /
  • 2020
  • /
  • 1976-9334(pISSN)
  • /
  • 2288-1522(eISSN)
한방비만학회 (The Society of Korean Medicine for obesity Research)
권호 표지
DOI QR코드

DOI QR Code

비만치료에 있어서 환자특성에 따른 인지행동요법과 행동수정요법의 효과 비교: 체계적 문헌고찰 및 메타분석

Comparison of the Effects of Cognitive Behavioral Therapy and Behavioral Treatment on Obesity Treatment by Patient Subtypes: A Systematic Review and Meta-analysis

  • 투고 : 2020.10.26
  • 심사 : 2020.11.21
  • 발행 : 2020.12.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: The present study aimed to compare the impacts of cognitive behavioral therapy (CBT) and behavioral treatment (BT) on weight loss and psychological outcomes among patients with three different subtypes of obesity: simple obesity, obesity with binge eating disorder, and obesity with depression. Methods: Embase, PubMed, the Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Korean Studies Information Service System were systematically searched for randomized controlled trials conducted on or before May 2020, that used CBT to treat obesity. Methodological quality was assessed using Cochrane's risk of bias tool 2 and publication bias was evaluated through the funnel plot using the trim and fill method, Egger's test, and Begg and Mazumdar rank correlation test. A meta-analysis was conducted using a random-effects model and the standardized mean difference with 95% confidence interval (CI) was used to determine effect size. Results: Twenty-one randomized controlled trials with a total of 22 intervention arms and 2,590 patients were included. Our study results revealed that the effects of CBT, compared with BT, on weight loss distinctly differed across all patient subgroups. In the simple obesity group, CBT was more effective than BT (Hedges' g=0.138, CI=0.012~0.264); however, in the obesity with binge eating disorder group, BT was more effective than CBT (Hedges' g=-0.228, CI=-0.418~-0.038); in the obesity with depression group, the effect of CBT was not statistically different from that of BT (Hedges' g=0.276, CI=-0.307~0.859). Further studies with larger sample sizes are required to confirm the outcomes observed in this study. Conclusions: Our results indicated that the effects of CBT on obesity treatment vary based on patient subtype. Therefore, our findings suggest that CBT or BT should be selectively recommended as a treatment strategy for different obesity subtypes.

키워드

참고문헌

  1. World Health Organization. Obesity and overweight [Internet]. Geneva: World Health Organization; 2020 [cited 2020 April 1]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
  2. Dobbs R, Sawers C, Thompson F, Manyika J, Woetzel J, Child P, et al. Overcoming obesity: an initial economic analysis. London : McKinsey Global Institute. 2014.
  3. Shaw K, O'Rourke P, Del Mar C, Kenardy J. Psychological interventions for overweight or obesity. Cochrane Database Syst Rev. 2005 ; 2 : CD003818.
  4. Castelnuovo G, Pietrabissa G, Manzoni GM, Cattivelli R, Rossi A, Novelli M, et al. Cognitive behavioral therapy to aid weight loss in obese pa tients: current perspectives. Psychol Res Behav Manag. 2017 ; 10 : 165-73. https://doi.org/10.2147/PRBM.S113278
  5. Darby A, Hay P, Mond J, Quirk F, Buttner P, Kennedy L. The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005. Int J Eat Disord. 2009 ; 42(2) : 104-8. https://doi.org/10.1002/eat.20601
  6. de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry Res. 2010 ; 178(2) : 230-5. https://doi.org/10.1016/j.psychres.2009.04.015
  7. Jacob A, Moullec G, Lavoie KL, Laurin C, Cowan T, Tisshaw C, et al. Impact of cognitive-behavioral interventions on weight loss and psychological outcomes: a meta-analysis. Health Psychol. 2018 ; 37(5) : 417-32. https://doi.org/10.1037/hea0000576
  8. Mannan M, Mamun A, Doi S, Clavarino A. Is there a bi-directional relationship between depression and obesity among adult men and women? Systematic review and bias-adjusted meta-analysis. Asian J Psychiatr. 2016 ; 21 : 51-66. https://doi.org/10.1016/j.ajp.2015.12.008
  9. Wadden TA, Butryn ML. Behavioral treatment of obesity. Endocrinol Metab Clin North Am. 2003 ; 32(4) : 981-1003. https://doi.org/10.1016/S0889-8529(03)00072-0
  10. Stahre L, Tarnell B, Hakanson CE, Hallstrom T. A randomized controlled trial of two weight-reducing short-term group treatment programs for obesity with an 18-month follow-up. Int J Behav Med. 2007 ; 14(1) : 48-55. https://doi.org/10.1007/BF02999227
  11. Peckmezian T, Hay P. A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders. J Eat Disord. 2017 ; 5 : 15. https://doi.org/10.1186/s40337-017-0143-5
  12. Palavras MA, Hay P, Dos Santos CA, Claudino A. The efficacy of psychological therapies in reducing weight and binge eating in people with bulimia nervosa and binge eating disorder who are overweight or obese-a critical synthesis and meta-analyses. Nutrients. 2017 ; 9(3) : 299. https://doi.org/10.3390/nu9030299
  13. Brownley KA, Berkman ND, Peat CM, Lohr KN, Cullen KE, Bann CM, et al. Binge-eating disorder in adults: a systematic review and meta-analysis. Ann Intern Med. 2016 ; 165(6) : 409-20. https://doi.org/10.7326/m15-2455
  14. Peat CM, Berkman ND, Lohr KN, Brownley KA, Bann CM, Cullen K, et al. Comparative effectiveness of treatments for binge-eating disorder: systematic review and network meta-analysis. Eur Eat Disord Rev. 2017 ; 25(5) : 317-28. https://doi.org/10.1002/erv.2517
  15. Faulconbridge LF, Driscoll CFB, Hopkins CM, Benforado BB, Bishop-Gilyard C, Carvajal R, et al. Combined treatment for obesity and depression: a pilot study. Obesity (Silver Spring). 2018 ; 26(7) : 1144-52. https://doi.org/10.1002/oby.22209
  16. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington : American Psychiatric Association. 2013.
  17. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009 ; 6 : e1000100. https://doi.org/10.1371/journal.pmed.1000100
  18. Grilo CM, Masheb RM. A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder. Behav Res Ther. 2005 ; 43(11) : 1509-25. https://doi.org/10.1016/j.brat.2004.11.010
  19. Wilson GT, Wilfley DE, Agras WS, Bryson SW. Psychological treatments of binge eating disorder. Arch Gen Psychiatry. 2010 ; 67(1) : 94-101. https://doi.org/10.1001/archgenpsychiatry.2009.170
  20. Grilo CM, Masheb RM, Wilson GT, Gueorguieva R, White MA. Cognitive-behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: a randomized controlled trial. J Consult Clin Psychol. 2011 ; 79(5) : 675-85. https://doi.org/10.1037/a0025049
  21. Linde JA, Simon GE, Ludman EJ, Ichikawa LE, Operskalski BH, Arterburn D, et al. A randomized controlled trial of behavioral weight loss treatment versus combined weight loss/depression treatment among women with comorbid obesity and depression. Ann Behav Med. 2011 ; 41(1) : 119-30. https://doi.org/10.1007/s12160-010-9232-2
  22. Pagoto S, Schneider KL, Whited MC, Oleski JL, Merriam P, Appelhans B, et al. Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the be active trial. Int J Obes (Lond). 2013 ; 37(11) : 1427-34. https://doi.org/10.1038/ijo.2013.25
  23. Munsch S, Biedert E, Meyer A, Michael T, Schlup B, Tuch A, et al. A randomized compa rison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorder. Int J Eat Disord. 2007 ; 40(2) : 102-13. https://doi.org/10.1002/eat.20350
  24. Grilo CM, White MA, Gueorguieva R, Ba rnes RD, Masheb RM. Self-help for binge eating disorder in primary care: a randomized controlled trial with ethnically and racially diverse obese patients. Behav Res Ther. 2013 ; 51(12) : 855-61. https://doi.org/10.1016/j.brat.2013.10.002
  25. Lawlor ER, Islam N, Bates S, Griffin SJ, Hill AJ, Hughes CA, et al. Third-wave cognitive behaviour therapies for weight management: a systematic review and network meta-analysis. Obes Rev. 2020 ; 21(7) : e13013. https://doi.org/10.1111/obr.13013
  26. Carriere K, Khoury B, Gunak MM, Knauper B. Mindfulness-based interventions for weight loss: a systematic review and meta-analysis. Obes Rev. 2018 ; 19(2) : 164-77. https://doi.org/10.1111/obr.12623
  27. Hayes SC, Villatte M, Levin M, Hildebrandt M. Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annu Rev Clin Psychol. 2011 ; 7 : 141-68. https://doi.org/10.1146/annurev-clinpsy-032210-104449
  28. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions, Version 6.0 (updated July 2019). London: Cochrane; 2019 [cited 2019 August 10]. Available from: http://www.training.cochrane.org/handbook.
  29. Lipsey MW, Wilson DB. Practical meta-analysis. Applied social research methods series (Vol. 49). Thousand Oaks, CA : Sage Publications. 2001.
  30. Becker BJ. Synthesizing standardized mean-change measures. Br J Math Stat Psychol. 1988 ; 41(2) : 257-78. https://doi.org/10.1111/j.2044-8317.1988.tb00901.x
  31. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. London : Wiley. 2009.
  32. Werrij MQ, Jansen A, Mulkens S, Elgersma HJ, Ament AJ, Hospers HJ. Adding cognitive therapy to dietetic treatment is associated with less relapse in obesity. J Psychosom Res. 2009 ; 67(4) : 315-24. https://doi.org/10.1016/j.jpsychores.2008.12.011
  33. Tanco S, Linden W, Earle T. Well-being and morbid obesity in women: a controlled therapy evaluation. Int J Eat Disord. 1998 ; 23(3) : 325-39. https://doi.org/10.1002/(SICI)1098-108X(199804)23:3<325::AID-EAT10>3.0.CO;2-X
  34. Ames GE, Perri MG, Fox LD, Fallon EA, De Braganza N, Murawski ME, et al. Changing weight-loss expectations: a randomized pilot study. Eat Behav. 2005 ; 6(3) : 259-69. https://doi.org/10.1016/j.eatbeh.2005.01.003
  35. Ramirez EM, Rosen JC. A comparison of weight control and weight control plus body image therapy for obese men and women. J Consult Clin Psychol. 2001 ; 69(3) : 440-6. https://doi.org/10.1037/0022-006X.69.3.440
  36. Annesi JJ. Supported exercise improves controlled eating and weight through its effects on psychosocial factors: extending a systematic research program toward treatment development. Perm J. 2012 ; 16(1) : 7-18. https://doi.org/10.7812/11-136
  37. Annesi JJ, Tennant GA. Mediation of social cognitive theory variables in the relationship of exercise and improved eating in sedentary adults with severe obesity. Psychol Health Med. 2013 ; 18(6) : 714-24. https://doi.org/10.1080/13548506.2013.766354
  38. Jamal SN, Moy FM, Mohamed MNA, Mukhtar F. Effectiveness of a group support lifestyle modification (GSLiM) programme among obese adults in workplace: a randomised controlled trial. PLoS One. 2016 ; 11(8) : e0160343. https://doi.org/10.1371/journal.pone.0160343
  39. Befort CA, Nollen N, Ellerbeck EF, Sullivan DK, Thomas JL, Ahluwalia JS. Motivational interviewing fails to improve outcomes of a behavioral weight loss program for obese African American women: a pilot randomized trial. J Behav Med. 2008 ; 31(5) : 367-77. https://doi.org/10.1007/s10865-008-9161-8
  40. Annesi JJ. Relations of changes in self-regulatory efficacy and physical self-concept with improvements in body satisfaction in obese women initiating exercise with cognitive-behavioral support. Body Image. 2010 ; 7(4) : 356-9. https://doi.org/10.1016/j.bodyim.2010.05.001
  41. Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997 ; 315(7109) : 629-34. https://doi.org/10.1136/bmj.315.7109.629
  42. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994 ; 50(4) : 1088-101. https://doi.org/10.2307/2533446
  43. Manzoni GM, Cesa GL, Bacchetta M, Castelnuovo G, Conti S, Gaggioli A, et al. Virtual reality-enhanced cognitive-behavioral therapy for morbid obesity: a randomized controlled study with 1 year follow-up. Cyberpsychol Behav Soc Netw. 2016 ; 19(2) : 134-40. https://doi.org/10.1089/cyber.2015.0208
  44. Marcon ER, Baglioni S, Bittencourt L, Lopes CL, Neumann CR, Trindade MR. What is the best treatment before bariatric surgery? exercise, exercise and group therapy, or conventional waiting: a randomized controlled trial. Obes Surg. 2017 ; 27(3) : 763-73. https://doi.org/10.1007/s11695-016-2365-z
  45. Rodriguez-Hernandez H, Morales-Amaya UA, Rosales-Valdez R, Rivera-Hinojosa F, Rodriguez-Moran M, Guerrero-Romero F. Adding cognitive behavioural treatment to either low-carbohydrate or low-fat diets: differential short-term effects. Br J Nutr. 2009 ; 102(12) : 1847-53. https://doi.org/10.1017/S0007114509991231
  46. Sterne JA, Gavaghan D, Egger M. Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol. 2000 ; 53(11) : 1119-29. https://doi.org/10.1016/S0895-4356(00)00242-0
  47. Amrhein V, Greenland S, McShane B. Scientists rise up against statistical significance. Nature. 2019 ; 567(7748) : 305-7. https://doi.org/10.1038/d41586-019-00857-9
  48. Wasserstein RL, Lazar NA. The ASA's statement on p-value: context, process, and purpose. Am Stat. 2016 ; 70(2) : 129-33. https://doi.org/10.1080/00031305.2016.1154108
  49. Ranganathan P, Pramesh CS, Buyse M. Common pitfalls in statistical analysis: Clinical versus statistical significance. Perspect Clin Res. 2015 ; 6(3) : 169-70. https://doi.org/10.4103/2229-3485.159943
  50. Markowitz S, Friedman MA, Arent SM. Understanding the relation between obesity and depression: causal mechanisms and implications for treatment. Clin Psychol Sci Prac. 2008 ; 15 : 1-20. https://doi.org/10.1111/j.1468-2850.2008.00106.x
  51. Grilo CM, White MA, Masheb RM. DSM-IV psychiatric disorder comorbidity and its correlates in binge eating disorder. Int J Eat Disord. 2009 ; 42(3) : 228-34. https://doi.org/10.1002/eat.20599
  52. Straus S, Moher D. Registering systematic reviews. CMAJ. 2010 ; 182(1) : 13-4. https://doi.org/10.1503/cmaj.081849