Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men

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

Clare Robertson, Alison Avenell, Fiona Stewart, Daryll Archibald, Flora Douglas, Pat Hoddinott, Edwin Van Teijlingen, Dwayne Boyers

Research output: Contribution to journalArticle

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Abstract

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.
Original languageEnglish
Pages (from-to)1096-1123
Number of pages28
JournalAmerican Journal of Men's Health
Volume11
Issue number4
Early online date30 Jun 2015
DOIs
Publication statusPublished - 1 Jul 2017

Fingerprint

Weight Loss
Reducing Diet
Randomized Controlled Trials
Maintenance
Weights and Measures
Exercise
Obesity
Bibliographic Databases
Confidence Intervals
confidence
Body Mass Index
Placebos
Clinical Trials
Diet
Group
Control Groups
evidence

Keywords

  • obesity
  • behavioral issues
  • men's health interventions
  • PHYSICAL-ACTIVITY INTERVENTIONS
  • OBESE MEN
  • HIGH-PROTEIN
  • ERECTILE DYSFUNCTION
  • FAT-METABOLISM
  • OVERWEIGHT MEN
  • EXERCISE
  • METAANALYSIS
  • OUTCOMES
  • PROGRAM

Cite this

Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men : A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project). / Robertson, Clare; Avenell, Alison; Stewart, Fiona; Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; Van Teijlingen, Edwin; Boyers, Dwayne.

In: American Journal of Men's Health, Vol. 11, No. 4, 01.07.2017, p. 1096-1123.

Research output: Contribution to journalArticle

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abstract = "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.",
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author = "Clare Robertson and Alison Avenell and Fiona Stewart and Daryll Archibald and Flora Douglas and Pat Hoddinott and {Van Teijlingen}, Edwin and Dwayne Boyers",
note = "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).",
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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).

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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.

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KW - HIGH-PROTEIN

KW - ERECTILE DYSFUNCTION

KW - FAT-METABOLISM

KW - OVERWEIGHT MEN

KW - EXERCISE

KW - METAANALYSIS

KW - OUTCOMES

KW - PROGRAM

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