There has been a significant rise in the worldwide prevalence of obesity over the past 50 years. Numerous diseases, high morbidity levels, and enormous healthcare expenditures are associated with this now pandemic-level health issue.

Recently, researchers from the Obesity Research Group at the Federal University of So Paulo, Brazil, evaluated three long-term treatments designed to improve the overall quality of life for adults with obesity.

The desire to control weight is common across society, as obesity significantly affects both physical and mental health. A 2017 meta-analysis of 72 studies involving a total of more than 1 million people concluded that 42% of the general adult population were trying to lose weight while 23% were trying to maintain their current weight.

People commonly assume that obesity is linked to an imbalance between food intake and physical activity. However, many other factors contribute to weight issues. These factors include the influence of a modern lifestyle that promotes overeating and the role of fat tissue in maintaining a constant, stable, internal balance.

Earlier research has shown that the causes of obesity are multifaceted and involve genetic makeup, socioeconomic status, and cultural influences. Psychological factors contributing to obesity include depression, trauma, and emotional eating.

Healthcare practitioners commonly use cognitive behavioral therapy (CBT) as an effective intervention tool to help people with excess body weight. Focusing on behavioral modification strategies, such as taking time to savor food and chewing slowly, helps enable stimulus control and reduce the quantity of food that people consume.

The new Brazilian study, which determines the effects of different approaches to obesity treatment, appears in the journal Frontiers in Nutrition. The researchers randomly assigned a total of 98 adults with obesity to one of three groups: an education and health group, a physical exercise group, and an interdisciplinary therapy plus CBT group.

Participants in the education and health group attended lectures on health topics, while those in the physical exercise group underwent physical training. Participants in the final group received physical training, nutritional advice, and both physical and psychological therapy.

The researchers used questionnaires designed to evaluate depression and anxiety, eating behavior, and quality of life during the study. Before and after the program, the scientists also evaluated quantitative measurements, including height, weight, and body mass index (BMI), along with metabolic parameters that they obtained from blood tests.

After 30 weeks, 43 participants remained in the program. The dropout rate was lowest for the interdisciplinary group and highest for the education and health group.

The interdisciplinary group saw the greatest behavioral changes relevant to weight control. Members of this group also reported an increased quality of life and reduced symptoms of depression and emotional eating behaviors.

The authors of the study explain: [The interdisciplinary and CBT group] promoted greater behavioral changes than the other two programs in factors relevant to weight control, such as activity level and dietary intake, resulting in more weight loss. Changes in almost all the variables investigated were observed.

In addition, the authors note that [a]s expected, a positive correlation was found in all groups between changes in depression and anxiety symptoms and emotional eating behavior.

Although the study participants in the interdisciplinary plus CBT group achieved better results in perceived quality of life, quantitative body measurements, and decreased depression symptoms, the team observed no changes in hormone levels and anxiety symptoms.

Dr. Mark Hoelterhoff, a professor in clinical psychology at the University of Edinburgh in the United Kingdom, was not involved in the study. He told Medical News Today that evidence indicates that depression is not only a cause of obesity but also, possibly, a symptom of our modern diet.

Dr. Hoelterhoff agreed with the findings of the Brazilian study, saying: Exercise and healthy eating programs alone are not sufficient to manage the obesity epidemic. Successful obesity programs cannot underestimate the need to promote self-efficacy and acceptance for people trying to improve their health.

The authors of the study stress that their findings highlight the need to focus more on the roles of anxiety and inflammation in obesity. They write:

It is essential to develop more powerful strategies to address this obesity epidemic and help individuals lose weight, as well as assist them in adopting and maintain a healthy lifestyle in a toxic environment that promotes excessive food consumption.

Overall, the authors conclude that the results of the study suggest that health-related quality of life and psychological issues may be key elements in the treatment of adults with obesity, and addressing these factors may contribute to advances in clinical actions.

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Tackling obesity: CBT, exercise, and education - Medical News Today