Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)

TY - JOUR

T1 - Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men

T2 - A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)

AU - Robertson, Clare

AU - Avenell, Alison

AU - Stewart, Fiona

AU - Archibald, Daryll

AU - Douglas, Flora

AU - Hoddinott, Pat

AU - Van Teijlingen, Edwin

AU - Boyers, Dwayne

N1 - Acknowledgements We thank the Men’s Health Forums of Scotland, Ireland, England, and Wales, especially Tim Street, Paula Carroll, Colin Fowler, and David Wilkins. We also thank Kate Jolly for information about the Lighten Up trial. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This review is an update of one of a series of systematic reviews for the ROMEO project (Review Of MEn and Obesity), funded by the National Institute for Health Research, Health Technology Assessment Programme (NIHR HTA Project 09/127/01; Systematic reviews and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men http://www.nets.nihr.ac.uk/projects/hta/0912701).

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials’ registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program −3.2 kg, 95% confidence interval −4.8 to −1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was −4.9 kg, 95% confidence interval −5.9 to −4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.

AB - Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials’ registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program −3.2 kg, 95% confidence interval −4.8 to −1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was −4.9 kg, 95% confidence interval −5.9 to −4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.

KW - obesity

KW - behavioral issues

KW - men's health interventions

KW - PHYSICAL-ACTIVITY INTERVENTIONS

KW - OBESE MEN

KW - HIGH-PROTEIN

KW - ERECTILE DYSFUNCTION

KW - FAT-METABOLISM

KW - OVERWEIGHT MEN

KW - EXERCISE

KW - METAANALYSIS

KW - OUTCOMES

KW - PROGRAM

U2 - 10.1177/1557988315587550

DO - 10.1177/1557988315587550

M3 - Article

C2 - 26130729

VL - 11

SP - 1096

EP - 1123

JO - American Journal of Men's Health

JF - American Journal of Men's Health

SN - 1557-9883

IS - 4

ER -