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Peirson L, Douketis J, Ciliska D, et al. Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis. CMAJ Open. 2014;2(4):E306-17doi: 10.9778/cmajo.20140012.
Peirson, L., Douketis, J., Ciliska, D., Fitzpatrick-Lewis, D., Ali, M. U., & Raina, P. (2014). Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis. CMAJ open, 2(4), E306-17. https://doi.org/10.9778/cmajo.20140012
Peirson, Leslea, et al. "Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis." CMAJ open vol. 2,4 (2014): E306-17. doi: https://doi.org/10.9778/cmajo.20140012
Peirson L, Douketis J, Ciliska D, Fitzpatrick-Lewis D, Ali MU, Raina P. Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis. CMAJ Open. 2014 Oct 01;2(4):E306-17. doi: 10.9778/cmajo.20140012. eCollection 2014 Oct. PMID: 25485258; PMCID: PMC4251513.
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CMAJ Open. 2014 Oct 01;2(4):E306-17. doi: 10.9778/cmajo.20140012. eCollection 2014 Oct.

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

CMAJ open

Leslea Peirson, James Douketis, Donna Ciliska, Donna Fitzpatrick-Lewis, Muhammad Usman Ali, Parminder Raina

Affiliations

  1. McMaster Evidence Review and Synthesis Centre, McMaster University Hamilton, Ont.
  2. Department of Medicine, McMaster University, Hamilton, Ont. ; St. Joseph's HealthCare, Hamilton, Ont.

PMID: 25485258 PMCID: PMC4251513 DOI: 10.9778/cmajo.20140012

Abstract

BACKGROUND: Obesity is a major public health issue. This review updates the evidence on the effectiveness of behavioural and pharmacologic treatments for overweight and obesity in adults.

METHODS: We updated the search conducted in a previous review. Randomized trials of primary-care-relevant behavioural (diet, exercise and lifestyle) and pharmacologic (orlistat and metformin) with or without behavioural treatments in overweight and obese adults were included if 12-month, postbaseline data were provided for weight outcomes. Studies reporting harms were included regardless of design. Data were extracted and pooled wherever possible for 5 weight outcomes, 6 secondary health outcomes and 4 adverse events categories.

RESULTS: We identified 68 studies, most consisted of short-term (≤ 12 mo) treatments using diet (n = 8), exercise (n = 4), diet and exercise (n = 10), lifestyle (n = 19), orlistat (n = 25) or metformin (n = 4). Compared with the control groups, intervention participants had a greater weight loss of -3.02 kg (95% confidence interval [CI] -3.52 to -2.52), a greater reduction in waist circumference of -2.78 cm (95% CI -3.34 to -2.22) and a greater reduction in body mass index of -1.11 kg/m(2) (95% CI -1.39 to -0.84). The relative risk for loss of ≥ 5% body weight was 1.77 (95% CI 1.58-1.99, [number needed to treat 5, 95% CI 4-7]), and the relative risk for loss of ≥ 10% body weight was 1.91 (95% CI 1.69-2.16, [number needed to treat 9, 95% CI 7-12]). Incidence of type 2 diabetes was lower among pre-diabetic intervention participants (relative risk 0.62 [95% CI 0.50-0.77], number needed to treat 17 [95% CI 13-29]). With prevalence rates for type 2 diabetes on the rise, weight loss coupled with a reduction in the incidence of type 2 diabetes could potentially have a significant benefit on population health and a possible reduction in need for drug treatments for glycemic control.

INTERPRETATION: There is moderate quality evidence that behavioural and pharmacologic plus behvioural, treatments for overweight and obesity in adults lead to clinically important reductions in weight and incidence of type 2 diabetes in pre-diabetic populations.

REGISTRATION: PROSPERO no. CRD42012002753.

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