Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis

Peirson, Leslea; Douketis, James D.; Ciliska, Donna; Fitzpatrick‐Lewis, Donna; Ali, Muhammad Usman; Raina, Parminder

doi:10.9778/cmajo.20140012

Cited by 76 publications

(80 citation statements)

References 89 publications

(159 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…37 Meta-analyses of trials with behavioural interventions (e.g., diet, exercise and/or lifestyle components) indicated that participants who received the intervention (baseline mean BMI of 31-32) lost on average 3.1 kg more than participants in the control group (95% CI -3.9 to -2.4), lowered their BMI score by an additional 1.09 (95% CI -1.4 to -0.8), reduced their waist circumference by an additional 3.05 (95% CI -3.9 to -2.2) cm, and were more likely than controls to lose 5% or more (number needed to treat [NNT] 9; RR 1.8, 95% CI 1.4 to 2.3) and 10% or more total body weight (NNT 12; RR 2.0, 95% CI 1.3 to 3.2). 22 Intervention participants also had significantly greater (although clinically small) reductions in levels of total cholesterol, LDL cholesterol and fasting glucose, and systolic and diastolic blood pressure than controls (Table 1). No trials reported on overall mortality or disease incidence, except for type 2 diabetes.…”

Section: Adults At High Risk Of Diabetesmentioning

confidence: 95%

“…No significant difference in frequency of any adverse event, serious adverse event or withdrawal due to adverse events was reported between intervention groups and controls. 22 …”

Section: Behavioural Interventionsmentioning

confidence: 99%

“…22 Exercise alone (n = 4 studies) was not associated with weight loss. Subgroup analysis by duration of intervention showed no difference based on duration.…”

Section: Behavioural Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care

Brauer

Shaw

et al. 2015

CMAJ

135

125

View full text Add to dashboard Cite

CMET he prevalence of obesity in adults has increased worldwide and has almost doubled in Canada, from 14% in 1978/79 1 to 26% in [2009][2010][2011]2 with 2% of men and 5% of women having a body mass index (BMI) score greater than 40 (Appendix 1, available at www .cmaj.ca/lookup/suppl/doi :10.1503/cmaj .140887 /-/DC1).3 Over two-thirds of Canadian men (67%) and more than half of Canadian women (54%) are overweight or obese, based on measured weight.2-4 Excess weight is a well-recognized risk factor for several common chronic conditions, such as cardiovascular disease, cancer, type 2 diabetes, osteoarthritis and back pain. 5About two-thirds of adults who are overweight or obese were in the healthy weight range as adolescents, but gained weight in adulthood (about 0.5-1.0 kg every two years on average). 6,7 Slow weight gain may go unnoticed until health problems develop in middle age. However, this overall mean increase masks substantial variation in the population, and some people remain weight stable over long periods, whereas others experience substantial gains and losses. Currently, we cannot predict future health effects of weight gain over the life course.The causes of obesity are complex. Although excess adiposity is ultimately the result of an imbalance in the amount of energy consumed and the amount of energy expended by an individual, there are many biological, behavioural, social and environmental factors that interact to affect this balance. The dramatic increase in obesity since the 1970s, however, suggests environmental causes are prominent and potentially amenable to interventions and prevention. 8,9 Possible approaches include a wide range of legislative and policy options, in addition to health-promotion advice to maintain a healthy weight, increase physical activity and eat a healthy diet.10 Primary care providers have an important role in preventing and managing obesity through services offered to patients.Overweight or obese status is commonly assessed using the BMI. The internationally recognized cut-off BMI values for adults are as follows: underweight (< 18.5), normal weight (18.5-24.9), overweight (25-29.9) and obese (≥ 30). The obese category is further broken down by BMI into class I (30.0-34.9), class II (35.0-39.9) and class III (≥ 40).11 Distribution of body fat is also an independent indicator of health risk, and high waist circumference is associated with an increased risk for cardiovascular disease and type 2 diabetes. 12Lifestyle interventions (e.g., behavioural therapies, and dietary and physical activity programming and support) are the first line of treatment for most patients with overweight or obesity. Pharmacotherapy and surgery are options for more severe cases of obesity. A weight loss of 5% is considered clinically important, 13 as many cardiovascular risk factors (e.g., elevated blood pres-

show abstract

Section: Adults At High Risk Of Diabetesmentioning

confidence: 95%

“…No significant difference in frequency of any adverse event, serious adverse event or withdrawal due to adverse events was reported between intervention groups and controls. 22 …”

Section: Behavioural Interventionsmentioning

confidence: 99%

See 1 more Smart Citation

Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care

Brauer

Shaw

et al. 2015

CMAJ

135

125

View full text Add to dashboard Cite

show abstract

“…Similar methods have been used by and are reported in other publications authored by our review team. [13][14][15] …”

Section: Methodsmentioning

confidence: 99%

“…The absolute risk increase was 9.67%, and the number needed to screen for one child to be referred was 10 (95% CI [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The referral rate was also significantly higher in intervention group B than in the control group (RR 1.71, 95% CI 1.30-2.25).…”

Section: Referral Outcomesmentioning

confidence: 99%

Screening for developmental delay among children aged 1-4 years: a systematic review

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background: Existing guidelines on screening children less than 5 years of age for developmental delay vary. In this systematic review, we synthesized the literature on the effectiveness and harms of screening for developmental delay in asymptomatic children aged 1-4 years. Methods:We searched MEDLINE, Embase and PsychINFO for relevant articles published to June 16, 2015. We identified studies that included children aged 1-4 years who were not at high risk of developmental delay, screened in a primary care setting. Randomized trials and controlled cohort studies were considered for benefits (cognitive, academic and functional outcomes); no restrictions on study design were imposed for the review of harms.Results: Two studies were included. One used the Ages and Stages Questionnaire II for screening and reported significantly more referrals to early intervention in the intervention groups than in the control group (relative risk [RR] 1.95, 95% confidence interval [CI] 1.49-2.54, in the intervention group with office support and RR 1.71, 95% CI 1.30-2.25, in the intervention group without office support). The time to referral was 70% shorter in the intervention group with office support (rate ratio 0.30, 95% CI 0.19-0.48) and 64% shorter in the intervention group without office support (rate ratio 0.36, 95% CI 0.23-0.59), compared with the control group. The other study used the Vroeg Tijdige Onderkenning Ontwikkelingsstoornissen Language Screening instrument to screen children aged 15 months at enrolment for language delay. It reported no differences between groups in academic performance outcomes at age 8 years. Interpretation:The evidence on screening for developmental delay in asymptomatic children aged 1-4 years is inconclusive. Further research with longer-term outcomes is needed to inform decisions about screening and screening intervals. Within pediatric health care, policy decisions that address early detection and intervention for developmental delay involve a particularly complex balance of considerations. Parents of children with developmental disorders often report a sense of urgency to intervene as quickly as possible during essential developmental windows. There is also an important tension between intervening as early as possible and not overidentifying many children as developmentally delayed (i.e., too many false-positive findings). False-positive screen results for developmental delay can lead to unnecessary stigma, caregiver anxiety and excess cost, whereas false-negative results can lead to delays in treatment.Existing guidelines and recommendations for screening children for developmental delay vary. In 1994, the Canadian Task Force on the Periodic Health Examination (now the Canadian Task Force on Preventive Health Care) found fair evidence to assess developmental milestones at each well-baby visit. 5 In another guideline in the same year, 6 the task force found good evidence to recommend against the use of the Denver Developmental Screening Test 7 in asymptomatic preschool children, as wel...

show abstract

Effect of Integrated Behavioral Weight Loss Treatment and Problem-Solving Therapy on Body Mass Index and Depressive Symptoms Among Patients With Obesity and Depression

Rosas

et al. 2019

JAMA

105

View full text Add to dashboard Cite

IMPORTANCE Coexisting obesity and depression exacerbate morbidity and disability, but effective treatments remain elusive. OBJECTIVE To test the hypothesis that an integrated collaborative care intervention would significantly improve both obesity and depression at 12 months compared with usual care. DESIGN, SETTING, AND PARTICIPANTS The Research Aimed at Improving Both Mood and Weight (RAINBOW) randomized clinical trial enrolled 409 adults with body mass indices (BMIs) of 30 or greater (Ն27 for Asian adults) and 9-item Patient Health Questionnaire (PHQ-9) scores of 10 or greater. Primary care patients at a health system in Northern

show abstract

Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis

Cited by 76 publications

References 89 publications

Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care

Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care

Screening for developmental delay among children aged 1-4 years: a systematic review

Effect of Integrated Behavioral Weight Loss Treatment and Problem-Solving Therapy on Body Mass Index and Depressive Symptoms Among Patients With Obesity and Depression

Contact Info

Product

Resources

About