Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK.
BMJ. 2022 May 30;377:e069719. doi: 10.1136/bmj-2021-069719.
To examine the effectiveness of behavioural weight management interventions for adults with obesity delivered in primary care.
Systematic review and meta-analysis of randomised controlled trials.
Randomised controlled trials of behavioural weight management interventions for adults with a body mass index ≥25 delivered in primary care compared with no treatment, attention control, or minimal intervention and weight change at ≥12 months follow-up.
Trials from a previous systematic review were extracted and the search completed using the Cochrane Central Register of Controlled Trials, Medline, PubMed, and PsychINFO from 1 January 2018 to 19 August 2021.
Two reviewers independently identified eligible studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tool. Meta-analyses were conducted with random effects models, and a pooled mean difference for both weight (kg) and waist circumference (cm) were calculated.
Primary outcome was weight change from baseline to 12 months. Secondary outcome was weight change from baseline to ≥24 months. Change in waist circumference was assessed at 12 months.
34 trials were included: 14 were additional, from a previous review. 27 trials (n=8000) were included in the primary outcome of weight change at 12 month follow-up. The mean difference between the intervention and comparator groups at 12 months was -2.3 kg (95% confidence interval -3.0 to -1.6 kg, I=88%, P<0.001), favouring the intervention group. At ≥24 months (13 trials, n=5011) the mean difference in weight change was -1.8 kg (-2.8 to -0.8 kg, I=88%, P<0.001) favouring the intervention. The mean difference in waist circumference (18 trials, n=5288) was -2.5 cm (-3.2 to -1.8 cm, I=69%, P<0.001) in favour of the intervention at 12 months.
Behavioural weight management interventions for adults with obesity delivered in primary care are effective for weight loss and could be offered to members of the public.
PROSPERO CRD42021275529.
评估在初级保健中为肥胖成年人提供的行为体重管理干预措施的有效性。
系统评价和随机对照试验的荟萃分析。
在初级保健中为体重指数≥25 的成年人提供的行为体重管理干预措施与无治疗、对照注意力或最小干预以及≥12 个月随访时的体重变化的随机对照试验。
从以前的系统评价中提取试验，并使用 Cochrane 对照试验中心注册、Medline、PubMed 和 PsychINFO 从 2018 年 1 月 1 日至 2021 年 8 月 19 日进行搜索。
两位评审员独立确定合格研究，提取数据，并使用 Cochrane 偏倚风险工具评估偏倚风险。使用随机效应模型进行荟萃分析，并计算体重（kg）和腰围（cm）的 pooled mean difference。
主要结局是从基线到 12 个月的体重变化。次要结局是从基线到≥24 个月的体重变化。在 12 个月时评估腰围变化。
纳入 34 项试验：其中 14 项是来自之前综述的新增试验。27 项试验（n=8000）纳入了 12 个月随访时体重变化的主要结局。干预组与对照组在 12 个月时的差异为-2.3kg（95%置信区间-3.0 至-1.6kg，I=88%，P<0.001），有利于干预组。在≥24 个月（13 项试验，n=5011）时，体重变化的差异为-1.8kg（-2.8 至-0.8kg，I=88%，P<0.001），有利于干预组。干预组在 12 个月时腰围变化的差异为-2.5cm（-3.2 至-1.8cm，I=69%，P<0.001）。
在初级保健中为肥胖成年人提供的行为体重管理干预措施对于减肥是有效的，可以向公众提供。
PROSPERO CRD42021275529。
