SYSTEMATIC REVIEW OF THE EFFECTIVENESS OF INTERVENTIONS USED IN THE MANAGEMENT OF OBESITY

This paper briefly describes the principles of undertaking a systemati c review of the effectiveness of obesity management interventions. Obj ective: To assess the effectiveness of interventions used in the preve ntion and treatment of obesity and the maintenance of weight loss. Bac kground: Obesity represents a serious public health problem due to the associated risks of disease and mortality. Prevalence of the conditio n is increasing and the relevant Health of the Nation target is unlike ly to be met. Methods and search strategy: A qualitative systematic re view of the research literature, using electronic databases and contac t with experts. Inclusion criteria: Randomized controlled trials evalu ating the effectiveness of interventions used in managing obesity in w hich participants were observed for a minimum of 1 year. For studies o f prevention, non-randomized controlled trials with a concurrent contr ol group were also eligible. Results: Ninety-nine studies were include d, most of which had been performed in North America. The methodologic al quality of many of the studies was poor. Family therapy and communi ty education programmes were shown to be effective in preventing obesi ty in children and adults, respectively. Programmes based on the reduc tion of sedentary behaviour were effective in the treatment of obese c hildren. For the treatment of obese adults, behavioural, diet, exercis e and drug therapies can be effective when used in combination. Surger y is effective in morbidly obese patients. Weight regain is common fol lowing many types of weight loss interventions, and maintenance progra mmes based on continued contact may be useful. Conclusions: This revie w has identified some potentially effective interventions for the mana gement of obesity. However, results should be interpreted with caution due to problems with the methodological quality of primary studies.