Gudzune Kimberly A, Doshi Ruchi S, Mehta Ambereen K, Chaudhry Zoobia W, Jacobs David K, Vakil Rachit M, Lee Clare J, Bleich Sara N, Clark Jeanne M
Ann Intern Med. 2015 Apr 7;162(7):501-12. doi: 10.7326/M14-2238.
Commercial and proprietary weight-loss programs are popular obesity treatment options, but their efficacy is unclear.
To compare weight loss, adherence, and harms of commercial or proprietary weight-loss programs versus control/education (no intervention, printed materials only, health education curriculum, or <3 sessions with a provider) or behavioral counseling among overweight and obese adults.
MEDLINE and the Cochrane Database of Systematic Reviews from inception to November 2014; references identified by program staff.
Randomized, controlled trials (RCTs) of at least 12 weeks' duration; prospective case series of at least 12 months' duration (harms only).
Two reviewers extracted information on study design, population characteristics, interventions, and mean percentage of weight change and assessed risk of bias.
We included 45 studies, 39 of which were RCTs. At 12 months, Weight Watchers participants achieved at least 2.6% greater weight loss than those assigned to control/education. Jenny Craig resulted in at least 4.9% greater weight loss at 12 months than control/education and counseling. Nutrisystem resulted in at least 3.8% greater weight loss at 3 months than control/education and counseling. Very-low-calorie programs (Health Management Resources, Medifast, and OPTIFAST) resulted in at least 4.0% greater short-term weight loss than counseling, but some attenuation of effect occurred beyond 6 months when reported. Atkins resulted in 0.1% to 2.9% greater weight loss at 12 months than counseling. Results for SlimFast were mixed. We found limited evidence to evaluate adherence or harms for all programs and weight outcomes for other commercial programs.
Many trials were short (<12 months), had high attrition, and lacked blinding.
Clinicians could consider referring overweight or obese patients to Weight Watchers or Jenny Craig. Other popular programs, such as Nutrisystem, show promising weight-loss results; however, additional studies evaluating long-term outcomes are needed.
None. (
CRD4201-4007155).
商业性和 proprietary 的减肥项目是常见的肥胖治疗选择，但其疗效尚不清楚。
比较商业性或 proprietary 减肥项目与对照/教育（无干预、仅提供印刷材料、健康教育课程或与提供者进行少于 3 次会面）或行为咨询对超重和肥胖成年人的体重减轻、依从性及危害。
从创刊至 2014 年 11 月的 MEDLINE 和考克兰系统评价数据库；项目工作人员识别的参考文献。
至少为期 12 周的随机对照试验（RCT）；至少为期 12 个月的前瞻性病例系列（仅针对危害）。
两名评审员提取了关于研究设计、人群特征、干预措施以及体重变化平均百分比的信息，并评估了偏倚风险。
我们纳入了 45 项研究，其中 39 项为 RCT。在 12 个月时，慧俪轻体参与者的体重减轻幅度比分配到对照/教育组的参与者至少高 2.6%。珍妮·克莱格在 12 个月时导致的体重减轻幅度比对照/教育和咨询组至少高 4.9%。Nutrisystem 在 3 个月时导致的体重减轻幅度比对照/教育和咨询组至少高 3.8%。极低热量项目（健康管理资源公司、美迪法斯特和 OPTIFAST）导致的短期体重减轻幅度比咨询组至少高 4.0%，但据报告，6 个月后效果有所减弱。阿特金斯饮食法在 12 个月时导致的体重减轻幅度比咨询组高 0.1%至 2.9%。速瘦饮食法的结果不一。我们发现评估所有项目的依从性或危害以及其他商业项目体重结果的证据有限。
许多试验时间较短（<12 个月），损耗率高，且缺乏盲法。
临床医生可考虑将超重或肥胖患者转介至慧俪轻体或珍妮·克莱格。其他流行项目，如 Nutrisystem，显示出有前景的减肥效果；然而，需要更多评估长期结果的研究。
无。（
CRD4201 - 4007155）
