Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials

作者：Stephan U Dombrowski, Keegan Knittle, Alison Avenell, Vera Araújo‐Soares, Falko F. Sniehotta · 发表于：BMJ · 年份：2014 · DOI：10.1136/bmj.g2646 · 被引用次数：839 · 研究领域：Bariatric Surgery and Outcomes、Pharmacology and Obesity Treatment、Diet and metabolism studies

OBJECTIVE: To systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults and to assess the evidence for the effectiveness of these interventions. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Medline, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials. STUDY SELECTION: Studies were identified through to January 2014. Randomised trials of interventions to maintain weight loss provided to initially obese adults (aged ≥ 18) after weight loss of ≥ 5% body weight with long term (≥ 12 months) follow-up of weight change (main outcome) were included. STUDY APPRAISAL AND SYNTHESIS: Potential studies were screened independently and in duplicate; study characteristics and outcomes were extracted. Meta-analyses were conducted to estimate the effects of interventions on weight loss maintenance with the inverse variance method and a random effects model. Results are presented as mean differences in weight change, with 95% confidence intervals. RESULTS: 45 trials involving 7788 individuals were included. Behavioural interventions focusing on both food intake and physical activity resulted in an average difference of -1.56 kg (95% confidence interval -2.27 to -0.86 kg; 25 comparisons, 2949 participants) in weight regain compared with controls at 12 months. Orlistat combined with behavioural interventions resulted in a -1.80 kg (-2.54 to -1.06; eight comparisons, 1738 participants) difference c...