{"title":"Lost and not found: randomized controlled trial of cognitive behavioral therapy for weight-loss in patients with chronic kidney disease.","authors":"Katja Kurnik Mesarič, Jana Kodrič, Špela Bogataj, Andreja Marn Pernat, Aljoša Kuzmanovski, Bernarda Logar Zakrajšek, Jernej Pajek","doi":"10.1007/s10865-025-00583-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Managing obesity in patients with chronic kidney disease is crucial for managing disease progression. Psychological interventions, particularly cognitive behavioral therapy, can support lifestyle changes. This study aimed to evaluate the efficacy of a cognitive behavioral therapy intervention for obesity management in patients with chronic kidney disease.</p><p><strong>Methods: </strong>Forty patients with chronic kidney disease (stages 2-4) were randomized to either an intervention group (nutritional and physical activity counseling and 16-week cognitive behavioral therapy) or a control group (nutritional and physical activity counseling only). Primary outcomes were body mass index (BMI) and proteinuria.</p><p><strong>Results: </strong>The intervention group lost an average of 5.42 kg (BMI decrease: 1.82 kg/m²), compared to 1.53 kg (BMI decrease: 0.53 kg/m²) in the control group. A significant group-by-time interaction was observed for BMI (F(1,36) = 32.24, p = 0.004, ŋ²=0.21), favoring the intervention group. Effects remained significant at three-month follow-up, with an average weight loss of 4.63 kg (BMI decrease: 1.59 kg/m²) in the intervention group and 2.51 kg (BMI decrease: 0.87 kg/m²) in control group (F(2,70) = 5.54, p = 0.026, ŋ²=0.12). Changes in proteinuria did not differ between groups.</p><p><strong>Conclusion: </strong>Cognitive behavioral therapy was effective and well-tolerated for promoting weight loss with most of the lost weight maintained at the three-month follow-up. This intervention may offer a valuable non-pharmacological treatment option for weight management in patients with chronic kidney disease.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Behavioral Medicine","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1007/s10865-025-00583-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Managing obesity in patients with chronic kidney disease is crucial for managing disease progression. Psychological interventions, particularly cognitive behavioral therapy, can support lifestyle changes. This study aimed to evaluate the efficacy of a cognitive behavioral therapy intervention for obesity management in patients with chronic kidney disease.
Methods: Forty patients with chronic kidney disease (stages 2-4) were randomized to either an intervention group (nutritional and physical activity counseling and 16-week cognitive behavioral therapy) or a control group (nutritional and physical activity counseling only). Primary outcomes were body mass index (BMI) and proteinuria.
Results: The intervention group lost an average of 5.42 kg (BMI decrease: 1.82 kg/m²), compared to 1.53 kg (BMI decrease: 0.53 kg/m²) in the control group. A significant group-by-time interaction was observed for BMI (F(1,36) = 32.24, p = 0.004, ŋ²=0.21), favoring the intervention group. Effects remained significant at three-month follow-up, with an average weight loss of 4.63 kg (BMI decrease: 1.59 kg/m²) in the intervention group and 2.51 kg (BMI decrease: 0.87 kg/m²) in control group (F(2,70) = 5.54, p = 0.026, ŋ²=0.12). Changes in proteinuria did not differ between groups.
Conclusion: Cognitive behavioral therapy was effective and well-tolerated for promoting weight loss with most of the lost weight maintained at the three-month follow-up. This intervention may offer a valuable non-pharmacological treatment option for weight management in patients with chronic kidney disease.
慢性肾脏疾病患者的肥胖管理是控制疾病进展的关键。心理干预，特别是认知行为疗法，可以支持生活方式的改变。本研究旨在评估认知行为疗法干预慢性肾脏疾病患者肥胖管理的疗效。方法：40例慢性肾脏疾病（2-4期）患者随机分为干预组（营养和身体活动咨询和16周认知行为治疗）和对照组（仅营养和身体活动咨询）。主要结局是身体质量指数（BMI）和蛋白尿。结果：干预组体重平均减轻5.42 kg （BMI下降1.82 kg/m²），对照组体重平均减轻1.53 kg （BMI下降0.53 kg/m²）。BMI组间存在显著的组-时间交互作用（F(1,36) = 32.24, p = 0.004, n²=0.21），有利于干预组。在三个月的随访中，效果仍然显著，干预组平均体重减轻4.63 kg （BMI下降1.59 kg/m²），对照组平均体重减轻2.51 kg （BMI下降0.87 kg/m²）（F(2,70) = 5.54, p = 0.026, n²=0.12）。蛋白尿的变化在两组之间没有差异。结论：认知行为疗法对促进体重减轻有效且耐受性良好，在三个月的随访中大部分体重保持不变。这种干预可能为慢性肾脏疾病患者的体重管理提供有价值的非药物治疗选择。
期刊介绍：
The Journal of Behavioral Medicine is a broadly conceived interdisciplinary publication devoted to furthering understanding of physical health and illness through the knowledge, methods, and techniques of behavioral science. A significant function of the journal is the application of this knowledge to prevention, treatment, and rehabilitation and to the promotion of health at the individual, community, and population levels.The content of the journal spans all areas of basic and applied behavioral medicine research, conducted in and informed by all related disciplines including but not limited to: psychology, medicine, the public health sciences, sociology, anthropology, health economics, nursing, and biostatistics. Topics welcomed include but are not limited to: prevention of disease and health promotion; the effects of psychological stress on physical and psychological functioning; sociocultural influences on health and illness; adherence to medical regimens; the study of health related behaviors including tobacco use, substance use, sexual behavior, physical activity, and obesity; health services research; and behavioral factors in the prevention and treatment of somatic disorders. Reports of interdisciplinary approaches to research are particularly welcomed.
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