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Is a small change approach for weight management effective? A systematic review and meta‐analysis of randomized controlled trials

journal contribution
posted on 11.10.2021, 10:08 by Henrietta Emily Graham, Clare Deborah Madigan, Amanda DaleyAmanda Daley
Traditional weight management interventions typically involve people making large changes to their energy intake and/or expenditure and can be effective in the short-term, but weight regain is common. An alternative strategy is a small change approach, which asks people to make small(er) changes to their diet and/or physical activity behaviours (e.g., 100 kilocalories reduction or increases of 1,000 steps/day). This approach may lead to sustained weight management because such energy deficit goals are easier for people to integrate into their lives and then maintain. This systematic review and meta-analysis of randomised and quasi-randomised controlled trials assessed the effectiveness of a small change approach for weight management; 21 trials were included. In weight gain prevention trials with adults, the mean difference in weight change between groups was -0.7 kg (95% CI -1.0 to -0.4, 95% PI -1.1 to -0.3) at programme-end and -0.9 kg (95% CI -1.5 to -0.3, 95% PI -3.1 to 1.3) at last follow-up, favouring small change interventions. A small change approach was not effective for weight loss. Only 2/21 trials had a low risk of bias. Initial evidence supports the effectiveness of a small change approach for weight gain prevention, but not weight loss. Further high-quality trials with longer follow-up are required

Funding

NIHR, Department of Health and Social Care, China. Grant Number: NIHR300026

History

School

  • Sport, Exercise and Health Sciences

Published in

Obesity Reviews

Publisher

Wiley

Version

AM (Accepted Manuscript)

Rights holder

© 2021 World Obesity Federation

Publisher statement

This is the peer reviewed version of the following article: Graham, H.E., Madigan, C.D. and Daley, A., (2021). Is a small change approach for weight management effective? A systematic review and meta‐analysis of randomized controlled trials. Obesity Reviews. doi: 10.1111/obr.13357, which has been published in final form at https://doi.org/10.1111/obr.13357. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

Acceptance date

16/08/2021

Publication date

2021-09-28

ISSN

1467-7881

eISSN

1467-789X

Language

en

Depositor

Prof Amanda Daley. Deposit date: 8 October 2021