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

Abstract 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 have recommended that health professionals should consider behaviour 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 randomized controlled trails (RCTs). Data sources involved in the study are the Cochrane Library, MEDLINE, EMBASE, psycINFO 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 RCT’s 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 18years+ with a BMI>30kg/m2. The results revealed that lifestyle interventions targeting diet and physical activity are effective in sustaining weight loss up to 2years 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 terms weight loss, albeit limited. There was high heterogeneity among the studies; hence caution is required when interpreting the findings. Also, intention 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