Lifestyle interventions for weight loss in adults with severe obesity: a systematic review

Hassan, Yasmeen; Head, V; Jacob, Devakirubai; Bachmann, Max; Diu, S; Ford, John

doi:10.1111/cob.12161

Cited by 73 publications

(72 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Important issues highlighted by Hassan et al . included a lack of RCT evidence exclusively targeted at adults with a mean BMI >40 kg m −2 ; by including non‐RCT evidence we were able to capture studies exclusively targeted at adults with a mean BMI >40 kg m −2 .…”

Section: Discussionmentioning

confidence: 99%

“…Hassan et al . recently published a review examining the effectiveness of lifestyle interventions for adults with severe obesity. The review included 17 randomized controlled trials (RCTs) of at least 12‐weeks duration; participants receiving the lifestyle intervention had a greater decrease in weight than participants in the control group for all studies (1.0–11.5 kg).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exploring the evidence base for Tier 3 weight management interventions for adults: a systematic review

et al. 2017

View full text Add to dashboard Cite

Specialist weight management services provide a treatment option for severe obesity. The objective of the study is to review the characteristics, impact and practice implications of specialist weight management services for adults in the UK. Systematic review: EMBASE, MEDLINE and PsycINFO were searched from January 2005 to March 2016 with supplementary searches. Adults with a body mass index of ≥40 kg m , or ≥35 kg m with comorbidity or ≥30 kg m with type 2 diabetes and any study of multicomponent interventions, in any UK or Ireland setting, delivered by a specialist multidisciplinary team are the inclusion criteria. Fourteen studies in a variety of settings were included: 1 randomized controlled trial, 3 controlled and 10 observational studies. Mean baseline body mass index and age ranged from 40 to 54 kg m and from 40 to 58 years. The studies were heterogeneous making comparisons of service characteristics difficult. Multidisciplinary team composition and eligibility criteria varied; dropout rates were high (43-62%). Statistically significant reduction in mean body mass index over time ranged from -1.4 to -3.1 kg m and mean weight changes ranged from -2.2 to -12.4 kg. Completers achieving at least 5% reduction of initial body weight ranged from 32 to 51%. There was evidence for improved outcomes in diabetics. Specialist weight management services can demonstrate clinically significant weight loss and have an important role in supporting adults to manage severe and often complex forms of obesity. This review highlights important variations in provision and strongly indicates the need for further research into effective approaches to support severely obese adults.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring the evidence base for Tier 3 weight management interventions for adults: a systematic review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…While challenging, weight loss can be accomplished by a variety of lifestyle interventions (Wadden ; Hassan et al. ). However, weight loss and decreased energy intake result in physiologic and behavioral adaptations to restore homeostasis by encouraging increased energy intake to oppose weight loss and promote weight regain (Maclean et al.…”

Section: Introductionmentioning

confidence: 99%

Comparison of surgical versus diet‐induced weight loss on appetite regulation and metabolic health outcomes

et al. 2019

View full text Add to dashboard Cite

Bariatric surgery is associated with significant and sustained weight loss and improved metabolic outcomes. It is unclear if weight loss alone is the main mechanism of improved metabolic health. The purpose of this trial was to compare indices of appetite regulation, insulin sensitivity and energy intake ( EI ) between participants achieving 10 kg of weight loss via Roux‐en‐Y Gastric Bypass ( RYGB ) or dietary restriction ( DIET ); intake of a very low calorie liquid diet (800 kcal/d; 40% protein, 40% fat, 20% carbohydrate that matched the post‐ RYGB dietary protocol). Adults qualifying for bariatric surgery were studied before and after 10 kg of weight loss ( RYGB [ n = 6]) or DIET [ n = 17]). Appetite (hunger, satiety, and prospective food consumption [ PFC ]), appetite–related hormones, and metabolites (ghrelin, PYY , GLP ‐1, insulin, glucose, free fatty acids [ FFA ], and triglycerides [ TG ]) were measured in the fasting state and every 30 min for 180 min following breakfast. Participants were provided lunch to evaluate acute ad libitum EI , which was similarly reduced in both groups from pre to post weight loss. Fasting ghrelin was reduced to a greater extent following RYGB compared to DIET ( P = 0.04). Area under the curve ( AUC ) for ghrelin ( P = 0.01), hunger ( P < 0.01) and PFC ( P < 0.01) increased after DIET compared to RYGB , following 10 kg weight loss. Satiety AUC increased after RYGB and decreased after DIET ( P < 0.01). Glucose and insulin (fasting and AUC ) decreased in both groups. FFA increased in both groups, with a greater increase in AUC seen after RYGB versus DIET ( P = 0.02). In summary, appetite–related indices were altered in a manner that, if maintained, may promote a sustained reduction in energy intake with RYGB compared to DIET . Future work with a larger sample size and longer follow‐up will be important to confirm and extend these findings.

show abstract

“…While extensive lifestyle interventions can improve the effectiveness of behavioral interventions such as diet and exercise, successful long-term weight loss using these approaches in isolation have been routinely demonstrated as insufficiently efficacious for most adults [8]. Surgical interventions are highly effective but due to risks of complications are only reserved for morbidly obese patients.…”

Section: Introductionmentioning

confidence: 99%

The Gut Microbiome, Energy Homeostasis, and Implications for Hypertension

et al. 2017

View full text Add to dashboard Cite

Purpose of review The influence of gut bacteria upon host physiology is increasingly recognized, but mechanistic links are lacking. Diseases of energetic imbalance such as obesity and diabetes represent major risk factors for cardiovascular diseases such as hypertension. Thus, here we review current mechanistic contributions of the gut microbiota to host energetics. Recent findings Gut bacteria generate a multitude of small molecules which can signal to host tissues within and beyond the gastrointestinal tract to influence host physiology, and gut bacteria can also influence host digestive efficiency by altering the bioavailability of polysaccharides, yet the quantitative energetic effects of these processes remain unclear. Recently our team has demonstrated that gut bacteria constitute a major anaerobic thermogenic biomass, which can quantitatively account for obesity. Summary Quantitative understanding of the mechanisms by which gut bacteria influence energy homeostasis may ultimately inform the relationship between gut bacteria and cardiovascular dysfunction.

show abstract

Lifestyle interventions for weight loss in adults with severe obesity: a systematic review

Cited by 73 publications

References 24 publications

Exploring the evidence base for Tier 3 weight management interventions for adults: a systematic review

Exploring the evidence base for Tier 3 weight management interventions for adults: a systematic review

Comparison of surgical versus diet‐induced weight loss on appetite regulation and metabolic health outcomes

The Gut Microbiome, Energy Homeostasis, and Implications for Hypertension

Contact Info

Product

Resources

About