This randomized clinical trial looked at one of the biggest problems in obesity care: keeping weight off after a successful weight-loss phase. The researchers recruited 113 healthy adult women (ages 18–45) who had already lost at least 10% of their body weight through a structured weight-loss program and were now entering a 24-week “maintenance” period. Participants were randomly assigned to either a cognitive behavioral therapy (CBT) program plus the standard weight-maintenance diet, or to the same weight-maintenance diet alone. Importantly, both groups continued to receive biweekly visits with a dietitian during follow-up, so the main difference between groups was the addition of CBT sessions.

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The CBT intervention was delivered in 10 structured sessions (about 60 minutes each). Early sessions emphasized practical lifestyle and behavior skills such as goal setting, self-monitoring, improving eating habits at home, increasing daily activity, and problem solving. Later sessions introduced more cognitive strategies aimed at long-term maintenance, including working through unhelpful beliefs, coping strategies, body image, handling high-risk situations, and relapse prevention. Alongside this, participants continued individualized maintenance diet guidance based on their estimated energy needs, and were encouraged to maintain regular physical activity.

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By the end of 24 weeks, the CBT group maintained their weight loss more effectively than the control group. On average, participants who received CBT lost an additional small amount of weight during maintenance, while the control group regained weight, resulting in a meaningful between-group difference in weight change. Similar patterns were seen for BMI and waist circumference, with the CBT group showing better preservation (and slight further improvement) of these measures. Behaviorally, the CBT group also showed changes that are consistent with better long-term adherence: estimated energy intake decreased over time in the CBT group but increased in the control group, and daily step counts trended upward in the CBT group while declining in the control group.

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Notably, the study did not find meaningful differences between groups in lipid levels or glucose-related markers over the 24-week period, which the authors suggest may be because both groups had already improved their metabolic profiles during the initial successful weight-loss phase and because the maintenance-phase weight difference, while significant, was still modest. The authors also highlight limitations that matter for interpretation: the study included only women, lasted 24 weeks (so longer-term durability is unknown), and relied on self-reported diet records rather than fully objective intake measures.