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Cited by 442Obesity, Physical Activity, DietEating Disorders and BehaviorsObesity and Health Practices

Psychological interventions for overweight or obesity

Shaw, Kelly A, O'Rourke, Peter, Del Mar, Chris, Kenardy, Justin·2005·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd003818.pub2
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Abstract

BACKGROUND: Overweight and obesity are global health problems which are increasing throughout the industrialised world. If left unchecked, they will continue to contribute to the ever increasing noncommunicable disease burden. OBJECTIVES: To assess the effects of psychological interventions for overweight or obesity as a means of achieving sustained weight loss. SEARCH STRATEGY: Studies were obtained from searches of multiple electronic bibliographic databases. The date of the latest search was June 2003. SELECTION CRITERIA: Trials were included if the fulfilled the following criteria: 1) they were randomised controlled clinical trials of a psychological intervention versus a comparison intervention, 2) one of the outcome measures of the study was weight change measured by any method, 3) participants were followed for at least three months, 4) the study participants were adults (18 years or older) who were overweight or obese (BMI > 25 kg/m(2)) at baseline. DATA COLLECTION AND ANALYSIS: Two people independently applied the inclusion criteria to the studies identified and assessed study quality. Disagreement was resolved by discussion or by intervention of a third party. Meta-analyses were performed using a fixed effect model. MAIN RESULTS: A total of 36 studies met the inclusion criteria and were included in the review. Overall, 3495 participants were evaluated. The majority of studies assessed behavioural and cognitive-behavioural weight reduction strategies. Cognitive therapy, psychotherapy, relaxation therapy and hypnotherapy were assessed in a small number of studies. Behaviour therapy was found to result in significantly greater weight reductions than placebo when assessed as a stand-alone weight loss strategy (WMD -2.5 kg; 95% CI -1.7 to -3.3). When behaviour therapy was combined with a diet / exercise approach and compared with diet / exercise alone, the combined intervention resulted in a greater weight reduction. Studies were heterogeneous however the majority of studies favoured combining behaviour therapy with dietary and exercise interventions to improve weight loss. Increasing the intensity of the behavioural intervention significantly increased the weight reduction (WMD -2.3 kg; 95% CI -1.4 to - 3.3). Cognitive-behaviour therapy, when combined with a diet / exercise intervention, was found to increase weight loss compared with diet / exercise alone (WMD -4.9 kg; 95% CI -7.3 to - 2.4). No data on mortality, morbidity or quality of life were found. AUTHORS' CONCLUSIONS: People who are overweight or obese benefit from psychological interventions, particularly behavioural and cognitive-behavioural strategies, to enhance weight reduction. They are predominantly useful when combined with dietary and exercise strategies. The bulk of the evidence supports the use of behavioural and cognitive-behavioural strategies. Other psychological interventions are less rigorously evaluated for their efficacy as weight loss treatments.

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Authors
Shaw, K. A., O'Rourke, P., Del Mar, C., & Kenardy, J.
Affiliations
  • Department of Health and Human Services (AU)
  • The University of Queensland (AU)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2005-04-20
Issue
2
Pages
CD003818-CD003818
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd003818.pub2
OpenAlex
W2126635496
Cited by
442
References
114
Citations by year
2026: 2 · 2025: 5 · 2024: 6 · 2023: 8 · 2022: 11 · 2021: 13 · 2020: 26 · 2019: 12 · 2018: 25 · 2017: 23 · 2016: 21 · 2015: 40 · 2014: 47 · 2013: 37 · 2012: 30
Type
reference entry
Language
en
Status
Retracted
Update notices
Open access
closed
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Bond University Research Portal (Bond University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
Keywords
obesity, overweight, psychological intervention, weight loss, behavior therapy, cognitive behavioral therapy, diet and exercise, hypnotherapy, relaxation training, psychotherapy, non-communicable diseases, intervention intensity, combined diet and exercise intervention, placebo comparison, adults, quality of evidence, heterogeneity of results, risk of bias, publication bias, small sample bias
MeSH terms
Adult, Body Weight, Humans, Obesity, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic

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