Participant experiences of cognitive remediation therapy for obesity (CRT-O): a qualitative thematic analysis

Highlights: What are the main findings? Cognitive remediation therapy (CRT) has recently been employed in various clinical contexts to target maladaptive cognitive patterns, including those contributing to eating disorders in anorexia nervosa and binge eating disorder. There is early evidence that CRT can enhance cognitive flexibility, support behavioural changes, and improve self-regulation. What is the implication of the main finding? This study offers an in-depth qualitative perspective on the experiences of individuals with excess body weight undergoing a Cognitive Remediation Therapy (CRT) intervention. Our findings reveal significant emotional and cognitive shifts during and after the intervention, along with participants’ perceived benefits, challenges, long-term expectations, and concerns. The implication of these findings is that while CRT shows promise, its effectiveness is deeply intertwined with participants’ subjective experiences and the need for sustained support. The insights gained highlight the importance of integrating CRT strategies into daily life to address long-term expectations and concerns, ultimately emphasizing the necessity for ongoing, personalised support to maximize the benefits and ensure the longevity of the intervention’s impact on individuals living with excess body weight. Objective: The present study is a qualitative analysis of participant experiences and perspectives from people who received cognitive remediation therapy for adult obesity (CRT-O). Method: Post-intervention data were generated from an open-ended question requesting the participants to write, in the form of a letter to their therapist, about their experiences and reflections upon taking part in cognitive remediation therapy for adult obesity. Participants’ letters were thematically analyzed. Results: Four themes and nested subthemes emerged from participant responses, including (1) motivation and initial response to CRT-O for the adult obesity study eligibility process with the nested subthemes of initial apprehension pre-intervention and awareness and acknowledgement of one’s problematic eating behaviors; (2) perceived benefits from cognitive remediation therapy for adult obesity with the nested subthemes of the strategies and techniques that were found beneficial and the role of the cognitive remediation therapy for adult obesity therapists in facilitating positive change; (3) perceived outcomes post-intervention with the nested subthemes of changed relationship with food, self-acceptance and gaining control to effect positive lifestyle change; and (4) expectations and beliefs about the longer-term impact of cognitive remediation therapy for adult obesity with the nested subthemes of using the cognitive remediation therapy for adult obesity strategies as a lifestyle routine, apprehension about not having follow-up therapist support, and concern about potential relapse. Conclusion: Our analysis found helpful insights into the consumer perception of this novel intervention and highlighted the clinical utility of implementing cognitive remediation therapy in those living with a higher body weight.