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Clinical Research

Comprehensive cognitive training improves anthropometric measures in people with excess weight: the TRAINEP randomized controlled trial

International Journal of Obesity (2026)Cite this article

Subjects

Abstract

Objective

To evaluate the efficacy of a comprehensive cognitive intervention as an add-on to a standard behavioral weight-loss intervention (BWLI) in improving anthropometric measures in individuals with excess weight.

Participants

This randomized controlled trial included 148 participants (126 women; mean BMI = 31.62 kg/m²); 86.5% participants (n = 128) completed the study.

Methods

Participants were randomized into three groups: (1) Cognitive group (received four cognitive trainings: inhibitory control, approach-avoidance bias modification, implementation intentions, and episodic future thinking); (2) Sham group (received placebo cognitive interventions); and (3) Control group (no cognitive intervention). All three groups received BWLI. Cognitive trainings were delivered through four consecutive 90-min online group sessions. BMI, weight, percentage of weight loss (%WL), and waist-to-height ratio (WHtR) were assessed at baseline, post-treatment, and 3- and 6-month follow-ups. Mixed 3 (group) × 3 (time point) analysis were conducted to examine changes over time and between groups. Chi-squared test was used to explore group differences in reaching a clinically meaningful %WL.

Results

Significant group-by-time effects interactions were found for BMI (p = 0.009), weight (p = 0.003), %WL (p = 0.004) and WHtR (p = 0.041). Post hoc analyses showed greater reductions in all anthropometric measures in the Cognitive group compared to the Control group at post-intervention and at both follow-ups. Further, only the Cognitive group showed significant improvements over time. At 6-month follow-up, effect sizes were moderate in the Cognitive group, small in the Sham group, and negligible to small in the Control group. A higher proportion of participants in the Cognitive group achieved a clinically meaningful %WL.

Conclusions

A comprehensive cognitive training delivered as an add-on to BWLI improved anthropometric outcomes in individuals with excess weight, with sustained effects over 6 months.

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Data availability

The datasets generated and analyzed during the current study are available on the Open Science Framework (OSF) at https://osf.io/wj38y.

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Acknowledgements

This study was supported by the organizations listed in the Funding section.

Funding

This work was carried out with support from the following grants and institutions: the TRAINEP project [grant RTI2018–098771-B-I00] funded by the Spanish Ministry of Science, Innovation, and Universities [MCIN/AEI/ 10.13039/501100011033] and the European Regional Development Fund “FEDER A way of making Europe”; the INHIBE project [grant PDI2022-137524OB-I00] funded by the Spanish Ministry of Science, Innovation, and Universities [MCIN/AEI/10.13039/501100011033] and the European Social Fund Plus (FSE+); the BE-NEMOIC project [grant P21_00776] funded by the Consejería de Universidad, Investigación e Innovación (Junta de Andalucía); the Mind, Brain and Behavior Research Center [Grant CEX2023-001312-M/ funded by MCIN/AEI /10.13039/501100011033 and Grant UCEPP2023-11 funded by University of Granada]; Formación de Profesorado Universitario [Contract FPU2020-04540 (RGG)] funded by the Spanish Ministry of Science, Innovation and Universities; Research stays in foreign centres funded by Ministry of Science, Innovation and Universities [grant EST25/00046 (RGG) and PRX22/00698 (AC)] and the University of Granada [Plan Propio de Investigación y Transferencia 2024-Programa 10 (RGG and LSL)].

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Author notes

  1. These authors contributed equally: Lucía Solier-López, Raquel González-González

Authors and Affiliations

  1. Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain

    Lucía Solier-López, Raquel González-González, Alfonso Caracuel, José A. Puertas-González & Raquel Vilar-López

  2. Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia

    Antonio Verdejo-García

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  1. Lucía Solier-López
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Contributions

Lucía Solier-López: writing—original draft, data curation, formal analysis, investigation, and visualization. Raquel González-González: data curation, formal analysis, investigation, and writing—review and editing. Alfonso Caracuel: conceptualization, funding acquisition, methodology, project administration, supervision, validation, visualization, and writing—review and editing. Antonio Verdejo-García: conceptualization, methodology, resources, software, validation, visualization, and writing—review and editing. José A. Puertas-González: writing—review and editing. Raquel Vilar-López: conceptualization, funding acquisition, methodology, project administration, supervision, validation, visualization, and writing—review and editing.

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Correspondence to Lucía Solier-López.

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Solier-López, L., González-González, R., Caracuel, A. et al. Comprehensive cognitive training improves anthropometric measures in people with excess weight: the TRAINEP randomized controlled trial. Int J Obes (2026). https://doi.org/10.1038/s41366-025-02012-z

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