Recently, there has been a great deal of focus on intensive behavioral therapy (IBT) for overweight and obesity. IBT focuses on targeting ‘bad’ habits that contribute to poor diet and lifestyle choices and implementing personalized plans to correct them. In addition to meeting with your physician and nutritionist, you work regularly with a therapist to identify and treat any unseen barriers to a healthy lifestyle. As the name implies, the program involves frequent visits with your healthcare team over time and does require a full commitment from you to participate. You will learn to develop goals, create an exercise plan, track your eating habits, and alter your food/home environment to optimize results.
Technically, the Centers for Medicare and Medicaid Services (CMS) defines IBT as:
- Screening for obesity in adults using the measurement of BMI calculated by dividing
weight in kilograms by the square of height in meters (expressed kg/m2);
- Dietary (nutritional) assessment; and,
- Intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise.
On paper, this sounds like a good idea, but does it actually produce results? A recent randomized controlled trial attempts to answer this question. The study included 150 patients with obesity randomly assigned to IBT alone, IBT with the addition of liraglutide (a diabetes medication that has been repurposed for weight loss), or IBT + liraglutide + a low-calorie meal-replacement diet. Notably, all patients had documented previous attempts at weight loss and were unsuccessful.
After one year, the patients participating in IBT alone lost 6.1% of their weight on average, while the addition of liraglutide and/or the meal replacement roughly doubled the weight loss. Importantly, those that completed all the IBT visits lost an average of 9.1% of their weight, while those with lower attendance lost only 3.5% on average.
This was a well-conducted study showing that IBT does result in meaningful, but modest weight loss. Moreover, it also demonstrates that multiple combined strategies are even more effective. However, it is evident that in order to achieve the best results, this program requires strict adherence to the visits. Not all of us may be able to commit the time to such a program given the busy lives we lead, and some patients who do participate may still be unable to reach their weight loss goals for a variety of reasons. Therefore it is important to have an honest discussion with your healthcare team about what strategies are best for you. Oftentimes a combination of treatments, including non-surgical weight loss procedures such as ESG and weight loss medications, gives patients the best chance to achieve their goals. Find out more about our weight loss experts.