Peirson Leslea, Fitzpatrick-Lewis Donna, Ciliska Donna, Usman Ali Muhammad, Raina Parminder, Sherifali Diana
McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, McMaster University, Hamilton, Ont.
McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
CMAJ Open. 2015 Jan 13;3(1):E47-54. doi: 10.9778/cmajo.20140050. eCollection 2015 Jan-Mar.
Once weight loss is achieved, the challenge is to maintain this benefit. This review reports on the effectiveness of programs for weight-loss maintenance, as part of a larger review examining treatments for overweight and obese adults.
We updated the search of a 2011 review on screening and management of overweight and obese adults. Four databases were searched. For inclusion, participants had to have lost weight in treatment and then been randomly assigned to a weight-maintenance intervention or control conditions. Studies from the 2011 review that met the criteria were included. Data were extracted and pooled (where possible) for outcomes related to weight-loss maintenance.
Eight studies were included. Compared with control participants, intervention participants regained less weight (mean difference [MD] -1.44 kg, 95% confidence interval [CI] -2.42 to -0.47), regardless of whether the intervention was behavioural (MD-1.56 kg, 95% CI -3.10 to -0.02) or pharmacologic plus behavioural (MD -1.39 kg, 95% CI -2.86 to 0.08). Intervention participants also showed better weight maintenance than the control participants in terms of waist circumference (MD -2.30 cm, 95% CI -3.45 to -1.15) and body mass index (MD -0.95 kg/m(2), 95% CI -1.67 to -0.23). Participants undergoing pharmacologic plus behavioural interventions were more likely to maintain a loss of 5% or more of initial body weight than those in the control group (risk ratio [RR] 1.33, 95% CI 1.15 to 1.54); no difference was found for maintaining a weight loss of 10% or more (RR 1.76, 95% CI 0.75 to 4.12).
Moderate quality evidence shows that overweight and obese adults can benefit from interventions for weight maintenance following weight loss. However, there is insufficient evidence on the long-term sustainability of these benefits.
PROSPERO no. CRD42012002753.
一旦实现体重减轻，面临的挑战就是维持这一成果。本综述报告了体重维持计划的有效性，这是一项关于超重和肥胖成年人治疗方法的大型综述的一部分。
我们更新了对2011年超重和肥胖成年人筛查与管理综述的检索。检索了四个数据库。纳入的参与者必须在治疗中减轻了体重，然后被随机分配到体重维持干预组或对照组。纳入了2011年综述中符合标准的研究。提取并汇总（如有可能）与体重维持相关的结果数据。
纳入了八项研究。与对照组参与者相比，干预组参与者体重反弹较少（平均差值[MD] -1.44 kg，95%置信区间[CI] -2.42至-0.47），无论干预是行为干预（MD -1.56 kg，95% CI -3.10至-0.02）还是药物加行为干预（MD -1.39 kg，95% CI -2.86至0.08）。在腰围（MD -2.30 cm，95% CI -3.45至-1.15）和体重指数（MD -0.95 kg/m²，95% CI -1.67至-0.23）方面，干预组参与者的体重维持情况也优于对照组参与者。接受药物加行为干预的参与者比对照组更有可能维持初始体重减轻5%或更多（风险比[RR] 1.33，95% CI 1.15至1.54）；在维持体重减轻10%或更多方面未发现差异（RR 1.76，95% CI 0.75至4.12）。
中等质量证据表明，超重和肥胖成年人在体重减轻后可从体重维持干预中获益。然而，关于这些益处的长期可持续性证据不足。
PROSPERO编号CRD42012002753。
