Cognitive Behavioral Therapy May Not Help Prevent Weight Regain in Diabetics

Cognitive behavioral group therapy (CBGT), helps change thought patterns and behaviors, is an effective treatment for mental and physical health problems, like eating disorders but does not fair better for weight maintenance in type 2 diabetics. //

. According to the International Diabetes Federation (IDF), 80% of people with type 2 diabetes are overweight or obese at the time of diagnosis. Losing weight can reduce the risk of long-term cardiovascular illness and even death. However, current weight loss programmes for overweight and obese people with type 2 diabetes have not been shown to be effective in the long-term.

Unintentional Weight Gain - Symptom Evaluation
An inadvertent increase in bodyweight indicates weight gain. Necessary care like intake of a balanced diet and adequate physical activity is required to maintain good health and fitness.

‘Cognitive behavioral group therapy (CBGT) is no better than standard care at preventing weight regain after dieting in people with type 2 diabetes.’

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Can CBGT Help Diabetics To Keep Their Weight Off?

In this study, Dr Kirsten Berk from the Erasmus Medical Center, Rotterdam, the Netherlands and colleagues examined whether CBGT could help people with type 2 diabetes 'keep the weight off' after dieting.

The Prevention of Weight Regain (POWER) trial recruited 206 overweight or obese adults (BMI ?27 kg/m2) with type 2 diabetes from the outpatient diabetes-clinic at the Erasmus MC in the Netherlands.

Healthy Weight Gain during Pregnancy
Recommended weight gain during pregnancy is determined as per pre-pregnancy weight and BMI. Healthy weight gain is very important for pregnancy health and is achieved with the right diet and exercise.

All participants were put on a very low-calorie diet. After 8 weeks, 158 participants had achieved at least 5% weight loss and were randomised to either continue with usual care provided by their physician and diabetes nurse, or to receive CBGT (17 sessions over 18 months) in addition to usual care.

CBGT involved an experienced psychological therapist working with the group to identify and modify unhelpful thought patterns and behaviors around lifestyle, weight, body perception and relapse. The researchers compared the difference in body weight, weight regain, blood glucose, HbA1c, insulin dose, lipids, depression and anxiety between the groups over 2 years.

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The Need For Better Approaches

Two years after the start of treatment, weight regain was similar between the CBGT and usual care groups (control group regained an average 4.7 kg, CBGT group regained an average 4.0 kg). The results also showed that CBGT was no better than standard care at improving cardiovascular risk factors or psychological wellbeing.

Drugs Causing Weight Gain
Medications are among the lesser-known yet common causes of weight gain. Switching over to a lesser weight-promoting alternative can help to solve the issue of weight gain with medications.

The authors conclude: "Negative trials matter because they tell us what doesn't work, which is as important as what does. Our results provide no scientific justification to offer cognitive behavioral group therapy on top of usual care to optimise the effect of weight loss dieting in obese patients with type 2 diabetes. We urgently need to identify better approaches for long-term weight loss and weight maintenance in people with type 2 diabetes."

Source-Eurekalert