Systematic review of long‐term lifestyle interventions to prevent weight gain and morbidity in adults

Abstract

SummaryThe aim of this article is to determine the effectiveness of long-term lifestyle interventions for the prevention of weight gain and morbidity in adults. Prevention of weight gain is important in adults who are of normal weight, overweight and obese. A systematic review of controlled trials of lifestyle interventions in adults with a body mass index of less than 35 kg m -2 with at least 2 years of follow-up was carried out. Eleven of 39 comparisons produced significant improvement in weight between groups at 2 years or longer with mean difference weight change ranging from -0.5 to -11.5 kg. Effective interventions included a 600 kcal/day deficit diet deficit/low-fat diet (with and without meal replacements), low-calorie diet, Weight Watchers diet, low-fat non-reducing diet, diet with behaviour therapy, diet with exercise, diet with exercise and behaviour therapy. Adding meal replacements to a low-fat diet (with and without exercise and behaviour therapy) produced significant improvement in weight. Head-to-head interventions failed to show significant effect on weight with the exception of a Mediterranean diet with behaviour therapy compared with low-fat diet. Diet with exercise and/or behaviour therapy demonstrated significant reduction in hypertension and improvement in risk of metabolic syndrome and diabetes compared with no treatment control. Lifestyle interventions demonstrated significant improvement in weight, reduction in hypertension and reduction in risk of type 2 diabetes and the metabolic syndrome.

A systematic review of interventions aimed at the prevention of weight gain in adults

“…Brown et al reviewed interventions for both the prevention and treatment of obesity. The majority of studies were aimed at treatment, confirming the lack of high-quality interventions to prevent weight gain and in particular the lack of interventions targeted at the general population living in the community (10) .…”

Challenges with the Medicare Obesity Benefit: Practical Concerns & Proposed Solutions

“…Nearly half of the studies cited in the determination examined populations predominantly < 65 years of age. [13][14][15][16][17][18] Only three studies were pertinent to older adults: a weight-loss systematic review; 19 the ADAPT study; 20 and a study by Villareal,21 all aimed at encouraging functional improvement following weight loss. Studies conducted in primary care settings using IBT were limited, 22 as were those using function as the sole outcome measure.…”

Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions

“…While important advances have been made and successes realized [6,7], there are numerous examples of carefully designed and wellimplemented interventions that had small effects or were ineffective [8][9][10][11][12][13][14]. Effective interventions have shown diminished effectiveness when disseminated perhaps due to their complex nature and intensive components [15].…”