Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Weight-Loss Clinical Trials with a Minimum 1-Year Follow-Up

Franz, Marion J.; VanWormer, Jeffrey J.; Crain, A. Lauren; Boucher, Jackie L.; Histon, Trina; Caplan, William; Bowman, Jill D.; Pronk, Nicolas P.

doi:10.1016/j.jada.2007.07.017

Cited by 1,314 publications

(1,124 citation statements)

References 97 publications

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“…The mean weight loss for the three single-group studies (20,31,24) was 8.2±5 pounds, whereas the three quasi-experimental studies (24,25,28) and four randomized controlled trials (21–23,35) showed more modest average weight loss (6.2±.4 pounds and 3.4±2.9 pounds, respectively). The mean for the randomized controlled trials reviewed falls below the mean weight loss reported in meta-analyses of randomized controlled trials of lifestyle interventions tested in the general population, which was eight to 11 pounds (44,45). The difference in weight loss outcomes between the general population and persons with serious mental illness may be due to variability in treatment intensity, worse health status at baseline among persons with serious mental illness, or methodological differences across studies.…”

Section: Discussionmentioning

confidence: 79%

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Cabassa¹,

Ezell²,

Lewis‐Fernández³

2010

Psychiatric Services

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Objective The promotion of healthy lifestyles among persons with serious mental illness is an integral part of their recovery. The aims of this systematic literature review were to rate the methodological quality of lifestyle intervention outcome studies for persons with serious mental illness, summarize intervention strategies, examine physical health outcomes, and evaluate the inclusion of racial and ethnic minority groups in these studies. Methods Electronic bibliographic database searches were performed to locate studies conducted in the United States. Articles written in English and published in peer-reviewed journals between 1980 and 2009 were included. The authors used a standardized instrument to rate studies' methodological quality. Results Twenty-three articles were reviewed. Based on studies' methodological quality, three levels of evidence were found: single-group reports, quasi-experimental studies, and randomized controlled trials. Most interventions used behavioral techniques to improve dietary habits and increase physical activity. Twelve studies reported significant improvements in either weight loss or metabolic syndrome risk factors associated with receiving a lifestyle intervention. Persons from racial and ethnic minority groups were underrepresented, especially Hispanics and Asian Americans. Only one study included non–English-speaking participants. Conclusions Lifestyle interventions adapted to persons with serious mental illness show promise in reducing weight loss and some risk factors for metabolic syndrome. The under-representation of persons from racial or ethnic minority groups in this literature limits its generalizability. Implications for research and practice are discussed.

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Section: Discussionmentioning

confidence: 79%

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Cabassa¹,

Ezell²,

Lewis‐Fernández³

2010

Psychiatric Services

View full text Add to dashboard Cite

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“…Students were given guidance on binge-eating disorders and secondary causes of obesity. Students were also shown how exercise on its own is ineffective for weight-loss (21,22) which was illustrated by comparing the calories burned in an hour's high intensity exercise with different meal options from a well-known fast food chain.…”

Section: Supporting Knowledge Of Evidence Basementioning

confidence: 99%

Enabling tomorrow’s doctors to address obesity in a GP consultation: an action research project

Leedham‐Green

Pound

Wylie

2016

Education for Primary Care

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Enabling tomorrow's doctors to address obesity in a GP consultation: an action research project Obesity is a leading risk factor for morbidity and mortality, however guidelines for prevention and management are relatively recently established, and little is known about what needs to be in place to put these into practice.This research provides an insight into how senior medical students consult with obese patients in general practice, the range of their learning needs, and the impact of various educational strategies that aim to bring their practice closer to current evidence-based guidelines.It centres on a series of compulsory but formative reflective case studies written by final year students at one large medical school on their GP rotation as they consult independently with obese patients with 'next room' GP tutor support.Analysis of these case studies was used to inform a three-year educational action research project. By systematically identifying and addressing learning needs, including barriers and enablers to best practice, we have demonstrated how senior medical students, and their GP tutors, can acquire the role legitimacy and role competency required for effective practice.Keywords: obesity, medical education, behaviour change, health promotion, primary care, general practice Status Box What is already knownOur clinical and educational response to obesity is less well developed than our response to other risk factors for morbidity such as smoking. There are difficulties translating behavioural change and obesity guidelines into practice, and teaching tends to be inconsistent and vicarious with little understanding of the learning needs of students or how teaching translates into clinical practice. What this work addsThis paper gives insights into real-life encounters with obese patients providing a rich understanding of the learning needs of senior medical students. An action research methodology has been used to test approaches to addressing these needs, which have been tested in the clinical context. Suggestions for future work and researchA follow-up study looking at patient experiences and outcomes of consultations led by healthcare professionals trained using these approaches is needed.

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“…In Swedish obese Subjects (SoS) study, weight loss by conventional medical therapy was associated with 21.0% remission rate of T2DM at 2 years and 12.0% at 10 years (17). However, weight maintenance after conventional medical therapy is a problem, and most of the patients experience weight regain (18,19). Inability to maintain weight loss has impact on the recurrence of T2DM and increasing incidence of new cases of T2DM among the patients treated with conventional medical therapy (20).…”

Section: Surgical Treatment Of T2dm In Overweight and Obese Patientsmentioning

confidence: 99%

Surgery in the treatment of type 2 diabetes mellitus

et al. 2015

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Background and Aims: the prevalence of diabetes is increasing worldwide, and most of the cases are type 2 diabetes mellitus. the relationship between type 2 diabetes mellitus and obesity is well established, and surgical treatment is widely used for obese patients with type 2 diabetes mellitus. the aim was to present current knowledge about the possible mechanisms responsible for glucose control after surgical procedures and to review the surgical treatment results.Material and Methods: medical literature was searched for the articles presenting the impact of surgical treatment on glycemic control, long-term results, and possible mechanisms of action among obese individuals with type 2 diabetes mellitus.Results: remission of type 2 diabetes mellitus after bariatric surgery depends on the definition of the remission used. complete remission rate after surgery with the new criteria is lower than was considered before. randomized controlled studies demonstrate that surgery is superior to best medical treatment for the patients with type 2 diabetes mellitus. the recurrence of type 2 diabetes mellitus after bariatric surgery is observed in up to 40% of cases with ≥5 years of follow-up. despite the recurrence of type 2 diabetes mellitus in this group, better glycemic control and lower risk of macrovascular complications are present. incretin effects on glycemic control after bariatric surgery are well described, but the role of other possible mechanisms (bile acids, microbiota, intestinal gluconeogenesis) in humans is unclear.Conclusion: Surgery is an effective treatment of type 2 diabetes mellitus in obese patients. the most optimal surgical procedure for the treatment of obese patients with type 2 diabetes mellitus is still to be established. more research is needed to explore the mechanisms of glycemic control after bariatric surgery.

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Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Weight-Loss Clinical Trials with a Minimum 1-Year Follow-Up

Cited by 1,314 publications

References 97 publications

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Enabling tomorrow’s doctors to address obesity in a GP consultation: an action research project

Surgery in the treatment of type 2 diabetes mellitus

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