RT Journal Article
SR Electronic
T1 Strategies for weight maintenance in adult populations treated for overweight and obesity: a systematic review and meta-analysis
JF CMAJ Open
FD Canadian Medical Association
SP E47
OP E54
DO 10.9778/cmajo.20140050
VO 3
IS 1
A1 Peirson, Leslea
A1 Fitzpatrick-Lewis, Donna
A1 Ciliska, Donna
A1 Usman Ali, Muhammad
A1 Raina, Parminder
A1 Sherifali, Diana
YR 2015
UL http://www.cmajopen.ca/content/3/1/E47.abstract
AB Background Once weight loss is achieved, the challenge is to maintain this benefit. This review reports on the effectiveness of programs for weight-loss maintenance, as part of a larger review examining treatments for overweight and obese adults. Methods We updated the search of a 2011 review on screening and management of overweight and obese adults. Four databases were searched. For inclusion, participants had to have lost weight in treatment and then been randomly assigned to a weight-maintenance intervention or control conditions. Studies from the 2011 review that met the criteria were included. Data were extracted and pooled (where possible) for outcomes related to weight-loss maintenance. Results Eight studies were included. Compared with control participants, intervention participants regained less weight (mean difference [MD] –1.44 kg, 95% confidence interval [CI] –2.42 to –0.47), regardless of whether the intervention was behavioural (MD–1.56 kg, 95% CI –3.10 to –0.02) or pharmacologic plus behavioural (MD −1.39 kg, 95% CI –2.86 to 0.08). Intervention participants also showed better weight maintenance than the control participants in terms of waist circumference (MD –2.30 cm, 95% CI –3.45 to –1.15) and body mass index (MD –0.95 kg/m2, 95% CI –1.67 to –0.23). Participants undergoing pharmacologic plus behavioural interventions were more likely to maintain a loss of 5% or more of initial body weight than those in the control group (risk ratio [RR] 1.33, 95% CI 1.15 to 1.54); no difference was found for maintaining a weight loss of 10% or more (RR 1.76, 95% CI 0.75 to 4.12). Interpretation Moderate quality evidence shows that overweight and obese adults can benefit from interventions for weight maintenance following weight loss. However, there is insufficient evidence on the long-term sustainability of these benefits. Registration: PROSPERO no. CRD42012002753