Are interventions delivered by healthcare professionals effective for weight management? A systematic review of systematic reviews

Abstract

Objective: There are many systematic reviews of weight management interventions delivered by healthcare professionals (HCP), but it is not clear under what circumstances interventions are effective due to differences in review methodology. This review of systematic reviews synthesises the evidence about: (a) the effectiveness of HCP-delivered weight management interventions and (b) intervention and sample characteristics related to their effectiveness. Design: The review of reviews involved searching six databases (inception – October 2020). Reviews were included if they were (a) systematic, (b) weight management interventions delivered, at least partially, by HCP, (c) of randomised controlled trials and (d) written in English. Data regarding weight management outcomes (e.g. weight) and moderating factors were extracted. Secondary analyses were conducted using study-level data reported in each of the reviews. Setting: The review included studies that were delivered by HCP in any clinical or non-clinical setting. Participants: Not applicable. Results: Six systematic reviews were included (forty-six unique studies). First-level synthesis showed that weight management interventions delivered by HCP are effective. The second-level synthesis found that interventions are only successful for up to 6 months, are most effective for women, non-Caucasians and adults and are most effective if they have at least six sessions. Conclusions: As interventions are only successful for up to 6 months, they are not sufficient for achieving and maintaining a healthy weight.

The 18-month efficacy of an Intensive LifeStyle Modification Program (ILSM) to reduce type 2 diabetes risk among rural women: a cluster randomized controlled trial

“…In this study, we demonstrated that ILSM significantly reduced T2D scores and obtained statistically significant benefits for FBG, BMI, and intention to eat lowindex glycemic food at an 18-month follow-up based on the intention-to-treat analysis. This is encouraging as previous studies reported that the benefit of lifestyle interventions for diabetes prevention was typically sustained at 6 to 12 months [7]. This exciting result may suggest that early behavior interventions are expected to touch off a series of reciprocally reinforcing recursions and interactions via goal setting and ongoing environmental support, eventually driving intervention influence over time.…”

“…6 Department of Family and Community Medicine, University of California, San Francisco, CA 94118, USA. 7 School of Nursing, University of California, San Francisco, CA 94118, USA. 8 School of Nursing, Yale University, New Haven, CT 06520, USA.…”

“…However, maintaining lifestyle change over time is a well-recognized worldwide challenge, and few studies investigated the sustainability of lifestyle change in response to interventions [5,6]. In a recent umbrella review, the maximum benefit of lifestyle interventions for weight management was typically achieved at 6-month with a plateau or relapse reported over time, which suggests that lifestyle intervention effects may diminish over time [7]. In addition, according to a recent systematic review, over 90% of existing lifestyle interventions were conducted within 12-month follow-ups [8].…”

Identifying the effective behaviour change techniques in nutrition and physical activity interventions for the treatment of overweight/obesity in post-treatment breast cancer survivors: a systematic review

“…The importance of the role of a credible source, such as oncology counselor, has been highlighted in providing evidence-based information on the association of breast cancer and diet and physical activity in daily life in developing interventions effectively [ 68 ], and additionally in identifying the most important determinants of lifestyle changes in cancer survivors [ 69 ]. Moreover, it has been suggested that weight management interventions delivered by healthcare professionals can be effective for weight loss for up to 6 months [ 70 ]. The current findings concerning BCTs are in agreement with the aforementioned outcomes.…”

Public transport: lessons learned by the sector through the COVID-19 pandemic

“…However, by Phase 2, issues of understanding were more prominent, which was related to the messaging changing frequently and mitigations being implemented, removed and re-implemented. Guidance from behavioural scientists should be followed to promote understanding and compliance with public health messages [ 42 ], and also to better understand the social psychology of visible behavioural mitigations such as wearing face coverings [ 38 ]. Reliance on behavioural mitigations is complex.…”