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

Norbert Grabias; Radosław  Gryko; Maria Rajkowska; Aleksandra  Włodarczyk; Paulina  Jarząbek; Julia Weronika Mieszkowska; Anna Kinga Tejchma; Łukasz Dominik Woźniak; Bernard  Myszewski; Jędrzej  Piotrowski

doi:10.31435/ijitss.2(50).2026.5033

Authors

Norbert Grabias Karol Jonscher Municipal Medical Center, Milionowa 14, 93-113 Lodz, Lodzkie, Poland https://orcid.org/0009-0009-3681-5096
Radosław Gryko Copernicus Memorial Hospital, Pabianicka 62, 93-513 Lodz, Lodzkie, Poland https://orcid.org/0009-0002-8215-7011
Maria Rajkowska Copernicus Memorial Hospital, Pabianicka 62, 93-513 Lodz, Lodzkie, Poland https://orcid.org/0009-0005-2822-0595
Aleksandra Włodarczyk Copernicus Memorial Hospital, Pabianicka 62, 93-513 Lodz, Lodzkie, Poland https://orcid.org/0009-0007-5456-6703
Paulina Jarząbek Medical University of Lodz, Lodz, Łódź Voivodeship, Poland https://orcid.org/0009-0003-9859-1362
Julia Weronika Mieszkowska Healthcare Complex in Łęczyca, Zachodnia 6, 99-100 Łęczyca, Poland https://orcid.org/0009-0001-7699-9880
Anna Kinga Tejchma University Clinical Hospital No. 2 of the Medical University of Lodz, ul. S. Żeromskiego 113, 90-549 Lodz, Lodzkie, Poland https://orcid.org/0009-0007-7322-5517
Łukasz Dominik Woźniak Medical University of Lodz, Lodz, Łódź Voivodeship, Poland https://orcid.org/0009-0007-5634-3810
Bernard Myszewski Copernicus Memorial Hospital, Pabianicka 62, 93-513 Lodz, Lodzkie, Poland https://orcid.org/0009-0000-0027-0789
Jędrzej Piotrowski Copernicus Memorial Hospital, Pabianicka 62, 93-513 Lodz, Lodzkie, Poland https://orcid.org/0000-0001-8044-5496

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5033

Keywords:

Obesity, Digital Therapeutics, Cognitive Behavioral Therapy, mHealth, Systematic Review, Long-term Management

Abstract

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.

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