The effects of contemporary behavioural weight loss maintenance interventions for long term weight loss: a systematic review

Background A major challenge in the treatment of obesity is the long term maintenance of weight loss and prevention of weight regain. The Department of Health in England has recommended that health professionals should consider behavioural weight loss interventions. Objective To evaluate the effectiveness of behavioural weight loss interventions in maintaining long term weight loss. Methods Using the PRISMA statement we performed a systematic review of randomised controlled trials. Data sources involved in the study are the Cochrane Library, MEDLINE, EMBASE, psycINFO, CINAHL and the Web of Science. Studies were assessed independently by two authors to provide inter-rater reliability. Results This review presents the findings from 13 randomised controlled trials of weight loss maintenance utilising interventions that include diet strategies, behavioural strategies, lifestyle counselling and drug therapy, group therapy and the Internet. The sample population included adult participants of 18 years+ with a BMI>30kg/m(2). The results revealed that lifestyle interventions targeting diet and physical activity are effective in sustaining weight loss up to two years with extended care. Moreover, pharmacology combined with lifestyle interventions was effective. Conclusion There is important evidence that the use of behavioural weight loss interventions are effective in sustaining long term weight loss, albeit limited. There was high heterogeneity among the studies; hence caution is required when interpreting the findings. Also, intentions to treat principles and methods to handle missing data are not clearly reported across some studies. Blinding of participants and outcome assessors is very limited.