Improved Physical and Mental Health After a Combined Lifestyle Intervention with Cognitive Behavioural Therapy for Obesity

Mostafa Mohseni, Susanne Kuckuck, Renate E.H. Meeusen, Geranne Jiskoot, Robin Lengton, Mesut Savas, Kirsten A.C. Berk, Eline S. Van der Valk, Bibian Van der Voorn, Sjoerd A.A. Van den Berg, Anand M. Iyer, Johannes B.J. Bussmann, Pieter J.M. Leenen, Wim A. Dik, Cornelis J. de Groot, Erica L.T. Van den Akker, Elisabeth F.C. Van Rossum*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Obesity is a multifactorial, chronic, progressive disease associated with decreased health-related quality of life, co-morbidities, and increased mortality risk. Lifestyle interventions, focusing on dietetics, physical exercise, and behavioral therapy, are a cornerstone of therapy. Despite this very multidisciplinary treatment approach, the definition of treatment success is still based only on an average weight loss of ≥ 5%. However, the heterogeneous nature of obesity may necessitate a more comprehensive approach to assessing treatment effects. Objectives: Here, we describe changes in physiological, psychological, and behavioral health after a multidisciplinary combined lifestyle intervention (CLI). Additionally, we investigated whether these changes were related to weight loss. Methods: This prospective longitudinal study comprised 96 adults with obesity (73 women, 81 Caucasian) participating in a CLI at the Obesity Center CGG, Erasmus University Medical Center, Rotterdam, The Netherlands. The 1.5-year intervention comprised mul-tidisciplinary professional guidance towards a healthy diet, increased physical activity, and included cognitive behavioral therapy. Physiological health outcomes, psychological well-being, eating behavior, and physical activity were assessed after ten weeks and 1.5 years and compared to baseline. Results: An average of 5.2% weight loss (-6.0 kg) was accompanied by a mean 9.8% decrease in fat mass (-5.9 kg; both P < 0.001) and significant improvements in metabolism, hormonal status, and immune parameters (all P < 0.05). Moreover, we observed decreased psychopathology, increased quality of life, and decreased disordered eating (all P < 0.05). Weight loss correlated with most metabolic changes (all P < 0.05) but not with most psychological/behavioral changes. Conclusions: Combined lifestyle intervention in patients with obesity was accompanied by significant improvements in body weight and body composition along with cardiometabolic, endocrine, immunological, psychological, and behavioral improve-ments. Interestingly, most changes in psychological and behavioral health occurred independently of weight loss. Obesity treatment success should be evaluated based on a combination of physical and patient-reported outcomes rather than weight loss alone.

Original languageEnglish
Article numbere129906
JournalInternational Journal of Endocrinology and Metabolism
Issue number1
Publication statusPublished - Jan 2023

Bibliographical note

Funding Information:
E. F. C. v. R. is funded by a Vidi grant from the Netherlands Organization of Scientific Research NWO/ZONMW (grant number: 91716453). The Elisabeth Foundation financially supports E. F. C. v. R., E. L. T. v. d. A., and B. v. d. V.

Publisher Copyright:
© 2022, International Journal of Endocrinology and Metabolism.


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