Executive Function-Related Improvements on a Commercial CBT-Based Weight Management Intervention: Pilot Randomized Controlled Trial

Executive functioning is a key component involved in many of the processes necessary for effective weight management behavior change (e.g., setting goals). Cognitive behavioral therapy (CBT) and third-wave CBT (e.g., mindfulness) are considered first-line treatments for obesity, but it is unknown to what extent they can improve or sustain executive functioning in a generalized weight management intervention. This pilot randomized controlled trial examined if a CBT-based generalized weight management intervention would affect executive functioning and executive function-related brain activity in individuals with obesity or overweight. Participants were randomized to an intervention condition (N = 24) that received the Noom Weight program or to a control group (N = 26) receiving weekly educational newsletters. EEG measurements were taken during Flanker, Stroop, and N-back tasks at baseline and months 1 through 4. After 4 months, the intervention condition evidenced greater accuracy over time on the Flanker and Stroop tasks and, to a lesser extent, neural markers of executive function compared to the control group. The intervention condition also lost more weight than controls (-7.1 pounds vs. +1.0 pounds). Given mixed evidence on whether weight management interventions, particularly CBT-based weight management interventions, are associated with changes in markers of executive function, this pilot study contributes preliminary evidence that a multicomponent CBT-based weight management intervention (i.e., that which provides both support for weight management and is based on CBT) can help individuals sustain executive function over 4 months compared to controls.