认知行为疗法应对体重反弹的研究进展

doi:10.3969/j.issn.1674-8115.2025.11.014

摘要/Abstract

摘要：

超重和肥胖是全球范围内重要的公共卫生问题。尽管常规的综合干预手段能使许多超重和肥胖人群实现短期减重，但体重反弹问题依然普遍存在。认知行为疗法（cognitive behavioral therapy，CBT）作为一种以认知和行为改变为核心的心理干预手段，在体重管理研究中可使超重和肥胖的受试者更高效且健康地减轻体重，被视作减重的核心循证治疗模式之一。从神经机制角度，CBT能够加强超重和肥胖人群的大脑功能，调节奖赏系统，改变神经可塑性，从而显著延长减重后体重的维持时间。同时，CBT能够帮助超重和肥胖人群识别和改变不利于健康的思维模式，促进健康饮食和运动习惯的养成，有效抑制体重反弹的发生。随着CBT干预策略在减重研究中被广泛采纳，CBT的应用形式也在不断演变——从传统的面对面干预逐渐扩展到基于信息和通信技术的数字化干预；这不仅提高了干预的可及性和参与度，还为个体提供了更加个性化和便捷的减重支持。未来的研究应更多关注CBT的本土化和技术创新，使CBT拥有更强的可推广性，成为肥胖防控的重要工具，为改善公共健康作出更大贡献。

关键词: 认知行为疗法, 体重反弹, 减重, 体重维持

Abstract:

Overweight and obesity are among the major public health concerns worldwide. Although conventional comprehensive interventions often enable short-term weight loss, weight regain remains prevalent. Cognitive behavioral therapy (CBT), a psychological intervention focused on modifying cognitions and behaviors, has been shown to help individuals with overweight or obesity achieve weight loss more effectively and healthily. It is regarded as one of the core evidence-based treatment modalities for weight management. From a neurobiological perspective, CBT enhances brain function, modulates the reward system, and alters neuroplasticity in individuals with excess weight, thereby significantly extending weight maintenance duration after intervention. Furthermore, CBT assists this population in identifying and modifying health-impairing thought patterns, fostering the adoption of healthy eating and physical activity habits, and effectively curbing weight regain. As CBT strategies are increasingly integrated into weight loss research, their application continues to evolve—shifting from traditional face-to-face sessions to digitally enabled interventions based on information and communication technologies. This transition not only improves intervention accessibility and engagement but also offers more personalized and convenient support for weight management. Future research should prioritize the local adaptation and technological innovation of CBT to enhance its scalability, positioning it as a vital tool in obesity prevention and control and thereby contributing substantially to improve public health outcomes.

Key words: cognitive behavioral therapy (CBT), weight regain, weight loss, weight maintenance

中图分类号:

R749.055

徐雯奕, 张智若. 认知行为疗法应对体重反弹的研究进展[J]. 上海交通大学学报（医学版）, 2025, 45(11): 1545-1551.

XU Wenyi, ZHANG Zhiruo. Research progress on cognitive behavioral therapy in addressing weight regain[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(11): 1545-1551.

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