Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy.
Department of Neuroscience, University of Turin, 10124 Torino, Italy.
Nutrients. 2022 Mar 16;14(6):1259. doi: 10.3390/nu14061259.
After a low-calorie diet, only 25% of patients succeed in maintaining the result of weight loss for a long time. This systematic review and meta-analysis aims to explore whether patients undergoing intensive intervention during the maintenance phase have a greater preservation of the weight achieved during the previous slimming phase than controls. A bibliographic search was conducted using PubMed, Scopus, and Cochrane databases for clinical trials and randomised, controlled trials investigating the role of choice in weight-loss-maintenance strategies. Only studies with a follow-up of at least 12 months were considered. A total of eight studies, for a total of 1454 patients, was identified, each comparing a group that followed a more intensive protocol to a control group. Our metanalysis highlighted that an intensive approach even in the maintenance phase could be important to ensure greater success in the phase following the weight-loss period. However, it should be pointed out that the improvement was not so different from the trend of the respective controls, with a non-statistically significant mean difference of the effect size (0.087; 95% CI -0.016 to 0.190 = 0.098). This finding, along with the observation of a weight regain in half of the selected studies, suggests this is a long work that has to be started within the weight-loss phase and reinforced during the maintenance phase. The problem of weight control in patients with obesity should be understood as a process of education to a healthy lifestyle and a balanced diet to be integrated in the context of a multidisciplinary approach.
在低热量饮食后，只有 25%的患者能够长期维持减肥效果。本系统评价和荟萃分析旨在探讨在维持阶段接受强化干预的患者是否比对照组更能保持之前减肥阶段所达到的体重。使用 PubMed、Scopus 和 Cochrane 数据库对临床试验和随机对照试验进行了文献检索，以探讨选择在减肥维持策略中的作用。仅考虑了随访时间至少 12 个月的研究。确定了八项研究，共 1454 名患者，每项研究均比较了遵循更强化方案的组与对照组。我们的荟萃分析结果表明，即使在维持阶段采取强化方法也可能对确保减肥后阶段取得更大的成功很重要。然而，应该指出的是，这种改善与各自对照组的趋势并没有太大区别，效应大小的平均差异无统计学意义（0.087；95%CI -0.016 至 0.190 = 0.098）。这一发现，以及在选定研究中有一半出现体重反弹的观察结果表明，这是一项长期工作，必须在减肥阶段开始，并在维持阶段加强。肥胖患者的体重控制问题应被理解为向健康生活方式和均衡饮食进行教育的过程，应将其纳入多学科方法的背景中。
