The challenge of keeping it off, a descriptive systematic review of high‐quality, follow‐up studies of obesity treatments

Nordmo, Morten; Danielsen, Yngvild Sørebø; Nordmo, Magnus

doi:10.1111/obr.12949

Cited by 98 publications

(81 citation statements)

References 64 publications

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“…Preventing weight regain after weight loss (WL) remains the biggest challenge in obesity treatment. Behavioural interventions that address diet and physical activity are moderately effective in the short term, but most individuals experience significant weight regain (returning to baseline values) in the long term . However, successful weight loss maintenance (WLM) is critical to uphold health benefits .…”

Section: Introductionmentioning

confidence: 99%

Successful weight loss maintenance: A systematic review of weight control registries

et al. 2020

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Summary Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long‐term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer‐reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty‐two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.

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Section: Introductionmentioning

confidence: 99%

Successful weight loss maintenance: A systematic review of weight control registries

et al. 2020

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“…Weight-loss programs based on diet, exercise, and obesity drugs can help people lose weight, whereas maintaining weight loss seems to be the greatest challenge. [117][118][119] Even when obesity drugs are used during the maintenance phase, the vast majority regain most of the lost weight. 120 Considering that long-term TTh results in a progressive sustained reduction in obesity markers, combined with data showing that men may be more likely to regain weight after weight loss programs, 20,121 TTh holds tremendous potential as a unique obesity treatment for men.…”

Section: Tth In Comparison To Traditional Obesity Treatmentsmentioning

confidence: 99%

Testosterone Therapy for Prevention and Treatment of Obesity in Men

Caliber

Saad

2020

Androgens: Clinical Research and Therapeutics

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Testosterone deficiency (TD) is common in men with obesity. The association between TD and obesity is bidirectional; low testosterone (T) is a contributing cause to obesity, and obesity is a contributing cause to low T, creating a vicious circle. Most guidelines recommend weight loss by diet/exercise as the first point of intervention to stop this vicious cycle. However, it requires a large amount of weight loss that is maintained over time. In clinical practice, this is rarely achieved by lifestyle interventions. Bariatric surgery is currently the main obesity treatment modality that results in a large amount of weight loss with decent weight loss maintenance. However, bariatric surgery is an invasive and expensive procedure, with risk for complications. Considering the high prevalence of TD in men with obesity, a more practical and sustainable obesity treatment for men is testosterone therapy (TTh). Thanks to the metabolic effects of T, TTh results in more fat loss and preservation of fatfree mass, compared with diet/exercise interventions alone. In contrast to weight loss achieved by diet/exercise and bariatric surgery, TTh significantly preserves both muscle and bone mass. Further, TTh has psychological effects that may increase the motivation and ability of men to adhere to diet/exercise programs. Real-world evidence studies of long-term TTh for up to 11 years provide compelling evidence that TTh holds tremendous potential as a new treatment modality for obesity in men, with long-term weight loss maintenance and health benefits far exceeding those achieved by lifestyle interventions, approved obesity drugs, as well as bariatric surgery.

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“…Behavioural weight management programmes for the treatment of obesity have been found to be effective in the short‐term, but weight regain is common 1‐5 . In the context of an obesogenic environment, 6 individuals are subjected to an array of internal and external pressures that challenge the continuation of weight management behaviours.…”

Section: Introductionmentioning

confidence: 99%

Cognitive and behavioural strategies employed to overcome “lapses” and prevent “relapse” among weight‐loss maintainers and regainers: A qualitative study

et al. 2020

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Summary While many behavioural weight management programmes are effective in the short‐term, post‐programme weight regain is common. Overcoming “lapses” and preventing “relapse” has been highlighted as important in weight‐loss maintenance, but little is known on how this is achieved. This study aimed to compare the cognitive and behavioural strategies employed to overcome “lapses” and prevent “relapse” by people who had regained weight or maintained weight‐loss after participating in a weight management programme. By investigating differences between groups, we intended to identify strategies associated with better weight‐loss maintenance. Semi‐structured interviews were conducted with 26 participants (58% female) recruited from the 5‐year follow‐up of the Weight Loss Referrals for Adults in Primary Care (WRAP) trial (evaluation of a commercial weight‐loss programme). Participants who had lost ≥5% baseline weight during the active intervention were purposively sampled according to 5‐year weight trajectories (n = 16 'Regainers', n = 10 'Maintainers'). Interviews were audio‐recorded, transcribed verbatim, and analysed thematically. Key differences in strategies were that Maintainers continued to pay attention to their dietary intake, anticipated and planned for potential lapses in high‐risk situations, and managed impulses using distraction techniques. Regainers did not report making plans, used relaxed dietary monitoring, found distraction techniques to be ineffective and appeared to have difficulty navigating food within interpersonal relationships. This study is one of the longest qualitative follow‐ups of a weight loss trial to date, offering unique insights into long‐term maintenance. Future programmes should emphasize strategies focusing on self‐monitoring, planning and managing interpersonal relationships to help participants successfully maintain weight‐loss in the longer‐term.

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The challenge of keeping it off, a descriptive systematic review of high‐quality, follow‐up studies of obesity treatments

Cited by 98 publications

References 64 publications

Successful weight loss maintenance: A systematic review of weight control registries

Successful weight loss maintenance: A systematic review of weight control registries

Testosterone Therapy for Prevention and Treatment of Obesity in Men

Cognitive and behavioural strategies employed to overcome “lapses” and prevent “relapse” among weight‐loss maintainers and regainers: A qualitative study

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