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In a tertiary referral center, consecutively observed NAFLD subjects were offered a CBT program aimed at weight loss and increased physical activity, based on 13 group sessions; 68 cases entered the treatment protocol, those who refused (<jats:italic>n<\/jats:italic> = 82) were given recommendations for diet and physical activity. Treatment goals (weight loss \u22657% initial body weight, normalization of liver enzymes, and improved parameters of MS) were tested by logistic regression at 6 months (all cases) and at 2 years, both on intention\u2010to\u2010treat and in completers (Diet, 78; CBT, 65). The results were adjusted for the propensity score of attending the CBT program, based on civil, anthropometric and clinical variables. At baseline the CBT group had a larger prevalence of obesity and more severe insulin resistance (homeostasis model assessment (HOMA)). At follow\u2010up, CBT was associated with a higher probability of weight loss and normal liver enzymes (6\u2010month: odds ratio (OR), 2.56; 95% confidence interval (CI), 1.15\u20135.69; 2\u2010year intention\u2010to\u2010treat: OR, 3.57, 95% CI, 1.59\u20138.00), after adjustment for propensity and changes in body weight. A similar trend was observed in the outcome goals of insulin resistance and the score of MS, which were both reduced. In conclusion, subjects with NAFLD participating in a CBT program significantly improve their general and liver parameters. The beneficial effects are largely maintained at 2\u2010year follow\u2010up, in keeping with the lifestyle\u2010related pathogenesis of disease.<\/jats:p>","DOI":"10.1038\/oby.2010.254","type":"journal-article","created":{"date-parts":[[2010,10,21]],"date-time":"2010-10-21T14:31:34Z","timestamp":1287671494000},"page":"763-770","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Cognitive\u2010Behavioral Treatment of Nonalcoholic Fatty Liver Disease: A Propensity Score\u2010Adjusted Observational Study"],"prefix":"10.1002","volume":"19","author":[{"given":"Simona","family":"Moscatiello","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Di 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