A SYSTEMATIC REVIEW OF THE EFFICACY OF DIGITAL THERAPEUTICS (DTx) UTILIZING COGNITIVE BEHAVIORAL THERAPY (CBT) FOR LONG-TERM OBESITY MANAGEMENT IN ADULTS

Introduction: Obesity remains a critical global health challenge requiring scalable and sustainable intervention strategies. Digital Therapeutics (DTx) based on Cognitive Behavioral Therapy (CBT) offer a promising technological solution to overcome the limitations of traditional face-to-face treatments. Objective: This systematic review evaluated the long-term efficacy (minimum 6–12 months) of CBT-based DTx interventions in reducing Body Mass Index (BMI) and improving metabolic health in adults with obesity. Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed, Scopus, and Web of Science for Randomized Controlled Trials (RCTs) published between 2015 and 2025. Ten high-quality studies meeting the inclusion criteria were analyzed. Results: The synthesis of the included RCTs (n=10) demonstrates that DTx solutions utilizing self-monitoring, goal setting, and cognitive restructuring lead to clinically significant weight loss (up to -7.02 kg) and BMI reduction (e.g., -1.82kg/m2) compared to standard care. Long-term results indicate that while efficacy is high in the initial 6 months, user engagement significantly declines over time (attrition). However, blended care models combining digital tools with occasional human coaching showed superior sustainability (-6.8 kg at 12 months). Additionally, a "legacy effect" was observed, where metabolic benefits, such as improved blood pressure and reduced proteinuria, persisted despite partial weight regain. Conclusion: CBT-based DTx are effective tools for obesity management, particularly when implemented via hybrid models. Future research should focus on minimizing digital attrition and exploring the long-term cost-effectiveness of these interventions within public health systems.