Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials
Objective
To examine the effectiveness of behavioural weight management interventions for adults with obesity delivered in primary care.
Design
Systematic review and meta-analysis of randomised controlled trials.
Eligibility criteria for selection of studies
Randomised controlled trials of behavioural weight management interventions for adults with a body mass index ≥25 delivered in primary care compared with no treatment, attention control, or minimal intervention and weight change at ≥12 months follow-up.
Data sources
Trials from a previous systematic review were extracted and the search completed using the Cochrane Central Register of Controlled Trials, Medline, PubMed, and PsychINFO from 1 January 2018 to 19 August 2021.
Data extraction and synthesis
Two reviewers independently identified eligible studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tool. Meta-analyses were conducted with random effects models, and a pooled mean difference for both weight (kg) and waist circumference (cm) were calculated.
Main outcome measures
Primary outcome was weight change from baseline to 12 months. Secondary outcome was weight change from baseline to ≥24 months. Change in waist circumference was assessed at 12 months. Results 34 trials were included: 14 were additional, from a previous review. 27 trials (n=8000) were included in the primary outcome of weight change at 12 month follow-up. The mean difference between the intervention and comparator groups at 12 months was −2.3 kg (95% confidence interval −3.0 to −1.6 kg, I 2 =88%, P<0.001), favouring the intervention group. At ≥24 months (13 trials, n=5011) the mean difference in weight change was −1.8 kg (−2.8 to −0.8 kg, I 2 =88%, P<0.001) favouring the intervention. The mean difference in waist circumference (18 trials, n=5288) was −2.5 cm (−3.2 to −1.8 cm, I 2 =69%, P<0.001) in favour of the intervention at 12 months.
Conclusions
Behavioural weight management interventions for adults with obesity delivered in primary care are effective for weight loss and could be offered to members of the public.
Systematic review registration PROSPERO CRD42021275529.
Funding
National Institute for Health and Care Research (NIHR) Research Professorship award
NIHR Leicester Biomedical Research Centre
History
School
- Sport, Exercise and Health Sciences
Published in
BMJVolume
377Publisher
BMJ Publishing GroupVersion
- VoR (Version of Record)
Rights holder
© BMJ Publishing Group LtdPublisher statement
This is an Open Access article published by BMJ. This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).Acceptance date
2022-04-26Publication date
2022-05-30Copyright date
2022ISSN
1759-2151eISSN
0959-8138Publisher version
Language
- en