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
차진영†⋅김서영1†⋅신인수2⋅박영배⋅임영우
Jin-Young Cha†, Seo-Young Kim1†, In-Soo Shin2, Young-Bae Park, Young-Woo Lim
누베베 미병연구소, 1누베베 한의원 분당점, 2동국대학교 교육대학원
Nubebe Mibyeong Research Institute, 1Nubebe Korean Medical Clinic (Bundang), 2Graduate School of Education, Dongguk University
Young-Woo Lim
Nubebe Mibyeong Research Institute, 515 Seolleung-ro, Gangnam-gu, Seoul 06150, Korea
Tel: +82-70-5148-7608
Fax: +82-2-566-2252
E-mail: cash389@hanmail.net
†These authors contributed equally to this work for first authorship.
Nubebe Mibyeong Research Institute, 515 Seolleung-ro, Gangnam-gu, Seoul 06150, Korea
Tel: +82-70-5148-7608
Fax: +82-2-566-2252
E-mail: cash389@hanmail.net
†These authors contributed equally to this work for first authorship.
Received October 26, 2020; Revised November 19, 2020; Accepted November 21, 2020.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.- Abstract
- 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. - Keywords : Weight loss, Obesity, Cognitive behavioral therapy, Binge-eating disorder
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