Lost and not found

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.