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Third-wave cognitive behaviour therapies for weight management: systematic review and network meta-analysis protocol
  1. Emma R Lawlor1,
  2. Nazrul Islam1,
  3. Simon J Griffin1,2,
  4. Andrew J Hill3,
  5. Carly A Hughes4,5,
  6. Amy L Ahern1
  1. 1 MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
  2. 2 Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
  3. 3 Division of Psychological and Social Medicine, School of Medicine, University of Leeds, Leeds, UK
  4. 4 Fakenham Medical Practice, Norfolk, UK
  5. 5 University of East Anglia, Norwich Medical School, Norwich, UK
  1. Correspondence to Dr Emma R Lawlor; emma.lawlor{at}


Introduction Behavioural and cognitive behavioural programmes are commonly used to assist with weight management, but there is considerable scope to improve their effectiveness, particularly in the longer term. Third-wave cognitive behaviour therapies (CBTs) have this potential and are increasingly used. This systematic review will assess the effect of third-wave CBTs for weight management on weight, psychological and physical health outcomes in adults with overweight or obesity.

Methods and analysis The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidance. We will include studies of any third-wave CBTs focusing on weight loss or weight maintenance for adults with a body mass index (BMI) ≥25kg/m2. Eligible study designs will be randomised control trials, non-randomised trials, prospective cohort and case series. Outcomes of interest will be body weight/BMI, psychological and physical health, and adherence. We will search the following databases from inception to 16 January 2018: MEDLINE, CINAHL, Embase, Cochrane database (CENTRAL), PsycINFO, AMED, ASSIA and Web of Science. The search strategy will be based on the concepts: (1) third-wave CBTs and (2) overweight, obesity or weight management. No restrictions will be applied. We will search reference lists of relevant reviews and included articles. Two independent reviewers will screen articles for eligibility using a two-stage process. Two independent reviewers will extract data, assess risk of bias using Risk of Bias 2.0, Risk of Bias in Non-randomised studies of Interventions or Risk of Bias in Non-randomised Studies of Exposures checklist and assess quality using the Grading of Recommendations Assessment, Development and Evaluation tool. A random-effects network meta-analysis of outcomes, and sub-group analyses and meta-regression will be conducted, where data permit. If not appropriate, a narrative synthesis will be undertaken.

Ethics and dissemination Ethical approval is not required as no primary data will be collected. The completed systematic review will be disseminated in a peer-reviewed journal, presented at conferences and used to inform the development of a weight management programme.

PROSPERO registration number CRD42018088255.

  • third-wave cognitive behaviour therapy
  • weight management
  • weight loss
  • weight maintenance
  • overweight
  • obesity

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  • Contributors ALA, AJH and SJG conceived the study, participated in the study design, provided input on methods, participated in the development of the initial search strategy and contributed to the drafting of the manuscript. ERL participated in the study design, provided input on methods, developed the initial search strategy and was responsible for drafting the manuscript. NI provided input on methods, participated in the preparation of the initial manuscript draft and reviewed drafts. CAH contributed to the drafting of the manuscript and advising and recruiting patient and public involvement. All authors critically reviewed the manuscript and approved the final version submitted for publication.

  • Funding This protocol presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Reference Number RP-PG-0216-20010). ALA and SJG are supported by the Medical Research Council (MC_UU_12015/4). SJG is an NIHR senior investigator. The University of Cambridge has received salary support in respect of SJG from the National Health Service in the East of England through the Clinical Academic Reserve.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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