{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:44:27Z","timestamp":1791945867534,"version":"4.3.4"},"reference-count":69,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To examine the effectiveness of Internet\u2010delivered Cognitive Behaviour Therapy (ICBT) in improving psychosocial well\u2010being and promoting weight\u2010loss in adults \u2265\u200918\u2009years with BMI \u2265\u200925\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Global obesity engenders significant physical and psychosocial health consequences. Second\u2010wave ICBT focused on restructuring negative thoughts and behaviours has been explored as a potential intervention for elevated BMI and mental health concerns, but its effectiveness remains to be fully established, making further evaluation essential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Data Sources<\/jats:title>\n                    <jats:p>\n                      Eight databases were searched from inception to January 2025 for randomised controlled trials (RCTs), including participants \u2265\u200918\u2009years with BMI \u2265\u200925\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and second\u2010wave ICBT evaluating BMI, weight, depression, eating behaviours, and self\u2010esteem. This review followed PRISMA 2020. Study quality was assessed using the Cochrane Risk of Bias (ROB 2) and GRADE. Data were extracted using a modified Cochrane form. Random\u2010effects meta\u2010analysis calculated Standardised Mean Differences (SMD) with 95% confidence intervals, with subgroup analyses exploring heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine trials with 2278 participants were included. Significant improvements were seen in BMI, weight, and depressive symptoms while self\u2010esteem effects were small and non\u2010significant. Compared with passive controls, ICBT showed greater improvements in BMI and weight, whereas differences versus active control were smaller and inconsistent. Face\u2010to\u2010face CBT demonstrated superior outcomes for depression and self\u2010esteem. Male\u2010tailored interventions showed greater improvements. Shorter programmes yielded larger short\u2010term weight loss, while longer programmes supported more sustained effects. Narrative synthesis indicated improvements in emotional and external eating, with increased mindful and restrictive eating behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ICBT improved weight, BMI, and depressive symptoms, with limited evidence for self\u2010esteem. Male\u2010tailored interventions and longer programmes may enhance sustainable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Future ICBT programs should integrate strategies targeting sustainable weight loss and psychosocial well\u2010being to support long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>No Patient or Public Contribution<\/jats:title>\n                    <jats:p>Patients or members of the public were not involved, as this study synthesised previously published data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024497961\">PROSPERO<\/jats:ext-link>\n                      registration number: CRD42024497961\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70384","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:21:46Z","timestamp":1780892506000},"page":"4137-4158","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Internet\u2010Delivered Cognitive Behavioural Therapy (\n                    <scp>ICBT<\/scp>\n                    ) in Improving Weight\u2010Loss and Psychosocial Well\u2010Being Among Adults With High\n                    <scp>BMI<\/scp>\n                    : A Systematic Review"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4290-8672","authenticated-orcid":false,"given":"Sivaraman","family":"Suvetha","sequence":"first","affiliation":[{"name":"Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Mishra","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2581-4572","authenticated-orcid":false,"given":"Piyanee","family":"Klanin\u2010Yobas","sequence":"additional","affiliation":[{"name":"Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0138-5881","authenticated-orcid":false,"given":"Siriwan","family":"Lim","sequence":"additional","affiliation":[{"name":"Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"National University Health System  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5812\/ijpbs.113096"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010019\u20100717\u20109"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs\u201022544\/v1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.82632"},{"key":"e_1_2_12_6_1","volume-title":"The Foundation of Self\u2010Esteem","author":"Bailey J. 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