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Weight loss with non-surgical interventions in obese adults

This week's publication of the British Medical Journal examines long-term maintenence of weight loss with non-surgical interventions in obese adults.

News image

Dr Falko Sniehotta and colleagues from the United Kingdom systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults, and assessed the evidence for the effectiveness of these interventions.

The team performed a systematic review with meta-analysis of Medline, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials.

Studies were identified through to 2014.

Randomized trials of interventions to maintain weight loss provided to initially obese adults after weight loss of ≥5% body weight with long term follow-up of weight change were included.

The research team screened potential studies independently and in duplicate, and extracted study characteristics and outcomes.

Meta-analyses were conducted to estimate the effects of interventions on weight loss maintenance with the inverse variance method and a random effects model.

Results are presented as mean differences in weight change, with 95% confidence intervals.
Orlistat combined with behavioral interventions resulted in a −1.80 kg difference
British Medical Journal

The research team included 45 trials involving 7788 individuals.

Behavioral interventions focusing on both food intake and physical activity resulted in an average difference of −1.56 kg in weight regain compared with controls at 12 months.

The team found that orlistat combined with behavioral interventions resulted in a −1.80 kg difference compared with placebo at 12 months.

The team noted that all orlistat studies reported higher frequencies of adverse gastrointestinal events in the experimental compared with placebo control groups.

A dose-response relation for orlistat treatment was found, with 120 mg doses 3 times a day leading to greater weight loss maintenance compared with 60 mg and 30 mg three times a day.

Dr Sniehotta's team concludes, "Behavioral interventions that deal with both diet and physical activity show small but significant benefits on weight loss maintenance."

BMJ 2014;348:g2646
22 May 2014

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