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CFT Improves Depression and Emotional Eating in Severe Obesity: RCT Results

Key Takeaway
Consider CFT to improve psychological outcomes in patients with severe obesity.

This single-centre, examiner-blind randomized controlled trial evaluated the impact of Compassion Focused Therapy (CFT) on psychological outcomes in individuals with severe obesity (BMI ≥ 40 kg/m²). The study involved 91 participants randomized to either treatment as usual (n=46) or treatment as usual plus group-based CFT (n=45). The CFT intervention consisted of 10 weekly 2-hour sessions. Primary outcomes included self-compassion, depressive symptoms, emotional eating, shame, self-criticism, submissive behavior, and negative social comparison, assessed at pre-treatment, post-treatment, and three months post-intervention. Results demonstrated statistically and clinically significant improvements in all measured psychological outcomes for the CFT group compared to the control group, with p-values < 0.001. These improvements were sustained at the three-month follow-up. No adverse events related to the intervention were reported. Clinically, these findings suggest that CFT is an effective adjunctive psychological intervention for reducing psychological distress in individuals with severe obesity, potentially enhancing the efficacy of standard obesity treatments.

AI Accuracy Review: 9/10 · Auto-published
View Original Abstract ↓
BACKGROUND: Severe obesity (defined as a BMI ≥ 40 kg m-2) is often accompanied by significant mental health co-morbidities such as eating disorders and depressive disorder and people living with severe obesity often experience feelings of shame, self-criticism and feelings of inferiority in relation to others. Compassion Focused Therapy (CFT) was specifically designed for people with high levels of shame and self-criticism and aims to promote self-compassion which is regarded as an adaptive emotional regulation strategy. AIMS: To explore the effect on psychological outcomes of a 10-session (weekly for 2 hours) in-person, group-based CFT intervention for people living with severe obesity. We sought to determine whether CFT would lead to improved self-compassion, depressive symptoms, emotional eating, shame, self-criticism, submissive behavior, and negative social comparison. METHOD: A single-centre, randomized controlled trial was carried out with 91 participants allocated to either 'treatment as usual' (n = 46) or 'treatment as usual with additional group based CFT' (n = 45). Treatment as usual included dietary advice, assessment by a Consultant Endocrinologist with possible prescription of medication, and participation in an eight-week lifestyle modification programme. Psychological outcomes were recorded at three time points (pre-treatment, post-treatment, and three-months after the end of group-based CFT). RESULTS: CFT led to statistically and clinically significant improvements in self-compassion, self-coldness, mood, shame, emotional eating, self-criticism, social comparison, and submissive behaviour (all p < 0.001) compared with treatment as usual. These results were maintained at three-month follow-up. CONCLUSIONS: Group CFT appears to be an effective psychological intervention to alleviate psychological distress in people living with severe obesity. TRIAL REGISTRATION: ClinicalTrials.gov NCT03249441.
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