Robertson Clare, Avenell Alison, Boachie Charles, Stewart Fiona, Archibald Daryll, Douglas Flora, Hoddinott Pat, van Teijlingen Edwin, Boyers Dwayne
Health Services Research Unit, University of Aberdeen, UK.
Health Services Research Unit, University of Aberdeen, UK.
Obes Res Clin Pract. 2016 Jan-Feb;10(1):70-84. doi: 10.1016/j.orcp.2015.04.005. Epub 2015 Apr 30.
We systematically reviewed the randomised controlled trial (RCT) evidence for long-term (≥12 months) weight management interventions for obese men in contrast to women to help understand whether programmes should be designed differently for men. We searched 11 databases up to October 2014. Twenty-two RCTs reported data separately for men and women in weight loss or weight maintenance interventions. We found men were under-represented in RCTs of weight loss interventions open to both sexes. Men comprised 36% of participants (4771 from 13,305 participants). Despite this, men were 11% (95% CI 8-14%, p<0.001) more likely to be trial completers compared to women. The trials did not report service user consultation and none were designed to investigate whether men and women responded differently to given interventions. Our meta-analysis of 13 trials showed no significant difference in weight loss between men and women, either for weight loss in kg (p=0.90) or percentage weight loss (p=0.78), although men tended to lose more weight with intensive low fat reducing diets, with or without meal replacements, and structured physical activity/exercise programmes than women. Orlistat was less beneficial for men for weight maintenance. Individual support and tailoring appeared more helpful for men than women. We found evidence that men and women respond differently to, and have different preferences for, varying types of weight management programme. We suggest that it is important to understand men's views on weight loss, as this is likely to also improve the uptake and effectiveness of programmes for men.
我们系统地回顾了针对肥胖男性与女性的长期（≥12个月）体重管理干预措施的随机对照试验（RCT）证据，以帮助了解针对男性的项目设计是否应有所不同。我们检索了截至2014年10月的11个数据库。22项随机对照试验分别报告了男性和女性在减肥或体重维持干预措施中的数据。我们发现，在对男女都开放的减肥干预随机对照试验中，男性的代表性不足。男性占参与者的36%（13305名参与者中的4771名）。尽管如此，与女性相比，男性完成试验的可能性高11%（95%CI 8-14%，p<0.001）。这些试验没有报告与服务使用者的协商情况，也没有一项旨在调查男性和女性对特定干预措施的反应是否不同。我们对13项试验的荟萃分析表明，男性和女性在体重减轻方面没有显著差异，无论是以千克为单位的体重减轻（p=0.90）还是体重减轻百分比（p=0.78），尽管在有或没有代餐的强化低脂减肥饮食以及结构化体育活动/锻炼计划中，男性往往比女性减重更多。奥利司他对男性维持体重的益处较小。个体支持和个性化对男性似乎比对女性更有帮助。我们发现有证据表明，男性和女性对不同类型的体重管理计划的反应不同，偏好也不同。我们建议，了解男性对减肥的看法很重要，因为这可能也会提高针对男性的项目的接受度和有效性。
