Group versus one‐to‐one multi‐component lifestyle interventions for weight management: a systematic review and meta‐analysis of randomised controlled trials

Abstract

Background: Multi-component lifestyle interventions that incorporate diet, physical activity and behaviour change are effective for weight management. However, it is not clear whether delivery in a group or one-to-one format influences weight loss efficacy. The present study aimed to systematically review the evidence of the effectiveness of group compared to one-to-one multi-component lifestyle interventions for weight management.Methods: MEDLINE, EMBASE, CINAHL, CENTRAL and ISRCTN databases were searched from inception up to February 2020 for randomised controlled trials comparing group versus one-to-one multi-component lifestyle interventions for weight loss in adults with a body mass index ≥ 25 kg m -2 . The primary outcome was weight loss (kg) at 12 months and the secondary outcome was attainment of ≥5% weight loss at 12 months. Risk of bias was assessed using the Cochrane Risk of Bias Tool.Meta-analysis used random effects and estimated risk ratios and continuous inverse variance methods. Heterogeneity was investigated using I 2 statistics and sensitivity analyses.Results: Seven randomised controlled trials with 2576 participants were included. Group interventions were favoured over one-to-one interventions for weight loss at 12 months (−1.9 kg, 95% confidence interval = −1.3 to −2.6; I 2 = 99%). Participants of group interventions were more likely to attain ≥5% weight loss at 12 months relative to one-to-one interventions (relative risk = 1.58, 95% confidence interval = 1.25-2.00; I 2 = 60%). Conclusions: Group multi-component lifestyle interventions are superior for weight loss compared to one-to-one interventions with respect to adult weight management. Further research is required to determine whether specific components of group interventions can explain the superiority of weight loss outcomes in group interventions.

Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials

“…We searched for studies in the Cochrane Central Register of Controlled Trials, Medline, PubMed, and PsychINFO from 1 January 2018 to 19 August 2021 (see supplementary file 1). Reference lists of previous reviews 16 17 18 19 20 21 and included trials were hand searched.…”

Workplace wellness programs targeting weight outcomes in men: A scoping review

“…This review highlights that one‐on‐one and group‐based multicomponent lifestyle interventions are both efficacious strategies for weight management. With regard to what is more successful, group‐based multicomponent lifestyle interventions appear to have the edge over one‐on‐one approaches, at least in a community setting 71 . In a recent systematic review and meta‐analysis of RCTs by Abbott et al, 71 group interventions were favored over one‐to‐one interventions for weight loss (kg) at 12 months (−1.9 kg, 95% CI = −1.3, −2.6).…”

“…With regard to what is more successful, group‐based multicomponent lifestyle interventions appear to have the edge over one‐on‐one approaches, at least in a community setting 71 . In a recent systematic review and meta‐analysis of RCTs by Abbott et al, 71 group interventions were favored over one‐to‐one interventions for weight loss (kg) at 12 months (−1.9 kg, 95% CI = −1.3, −2.6). Admittedly, the study populations included in the review were heavily female dominated.…”

Real-World Data of a Group-Based Formula Low Energy Diet Programme in Achieving Type 2 Diabetes Remission and Weight Loss in an Ethnically Diverse Population in the UK: A Service Evaluation

“…This would suggest that the participants were able to maintain dietary adherence despite using a group-based programme, participants self-funding their meal replacement products and several groups running over a global pandemic. It is not entirely clear why this was the case, although a recent meta-analysis suggests group-based weight loss interventions may provide superior weight loss outcomes compared to one-to-one care [ 34 ] and rapid and early weight loss may lead to higher participant motivation and improved weight maintenance [ 15 , 16 ]. Service provision by a specialist MDT was a unique feature of our programme and may have contributed to superior weight loss outcomes [ 35 ] compared to previous studies [ 12 , 15 ], alongside the cultural adaptions made to meet participants needs.…”