Effectiveness of Internet-based Cognitive Behavioral Therapy in Weight Loss, Stress, Anxiety, and Depression via Virtual Group Therapy

Background: The obesity crisis is one of the major public health issues in the 21st century, and depression, anxiety, and stress are the psychological factors that mediate obesity. Objectives: This research was conducted to evaluate the effectiveness of internet-based cognitive-behavioral therapy (ICBT) in reducing body mass index (BMI), stress, anxiety, and depression in overweight women via a virtual group. Methods: This randomized controlled trial study was conducted on three groups of the experiment, the waiting list, and the treatment-as-usual. It was done as single-phase, single-center, and double-blinded. The statistical population included all women with BMI ≥ 25 in Neyshabur city in 2019 - 2020. The research sample included 90 subjects randomly assigned to the groups. The therapeutic intervention was applied in the form of 42 ICBT sessions using a virtual WhatsApp group. The participants completed the Depression Anxiety Stress Scale (DASS), and their BMI was also calculated before and after the sessions. Results: The analysis of covariance indicated the significant effect of ICBT on the reduction of BMI compared to the usual treatment group and waiting list group [F (72, 2) = 15.54, P < 0.0005; Partialη2 = 0.30]. However, it was not significant on the reduction of stress [F (72, 2) = 0.47, P = 0.63; Partialη2 = 0.01], anxiety [F (72, 2) = 0.49, P = 0.61; Partialη2 = 0.01], and depression [F (72, 2) = 0.06, P = 0.93; Partialη2 = 0.002]. Conclusions: The present study showed the direct effect of ICBT on the reduction of BMI like the treatment-as-usual for obesity. However, these sessions could not reduce the participants’ stress, anxiety, and depression.