scholarly journals Effectiveness and Characterization of Severely Energy-Restricted Diets in People with Class III Obesity: Systematic Review and Meta-Analysis

2019 ◽  
Vol 9 (12) ◽  
pp. 144 ◽  
Author(s):  
Gabrielle Maston ◽  
Alice A. Gibson ◽  
H. Reza Kahlaee ◽  
Janet Franklin ◽  
Elisa Manson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Prediction Interval ◽  
Meta Analysis ◽  
Average Weight ◽  
Class Iii ◽  
Dietary Interventions ◽  
Initial Body Weight ◽  
Class Iii Obesity

Severely energy-restricted diets are used in obesity management, but their efficacy in people with class III obesity (body mass index ≥40 kg/m2) is uncertain. The aims of this systematic review and meta-analysis were to determine the effectiveness and characteristics of severely energy-restricted diets in people with class III obesity. As there was a lack of publications reporting long-term dietary interventions and randomised controlled trial designs, our original publication inclusion criteria were broadened to include uncontrolled study designs and a higher upper limit of energy intake. Eligible publications reported studies including adults with class III obesity and that assessed a diet with daily energy intake ≤5000 kJ for ≥4 weeks. Among 572 unique publications from 4 databases, 11 were eligible and 10 were suitable for meta-analysis. Our original intention was to classify comparison arms into short-term (<6 months) and long-term (>1 year) interventions. Due to the lack of long-term data found, comparison arms were classified according to the commonalities in dietary intervention length among the included publications, namely dietary interventions of 4 weeks’ duration and those of ≥6 weeks’ duration. After a 4-week severely energy-restricted diet intervention, the pooled average weight loss was 9.81 (95% confidence interval 10.80, 8.83) kg, with a 95% prediction interval of 6.38 to 13.25 kg, representing a loss of approximately 4.1 to 8.6% of initial body weight. Diets ≥6 weeks’ duration produced 25.78 (29.42, 22.15) kg pooled average weight loss, with a 95% prediction interval of 13.77 to 37.80 kg, representing approximately 10.2 to 28.0% weight loss. Daily dietary prescriptions ranged from 330 to 5000 kJ (mean ± standard deviation 2260 ± 1400 kJ), and had wide variations in macronutrient composition. The diets were administered mostly via liquid meal replacement products. While the included publications had a moderate risk of bias score, which may inflate reported weight loss outcomes, the published data to date suggest that severely energy-restricted diets, delivered via diets of varying composition, effectively produce clinically relevant weight loss (≥10% of initial body weight) when used for 6 weeks or more in people with class III obesity.

Efficacy of interventions incorporating mobile applications in facilitating weight loss and health behavior change in the Asian population: a systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Siew Min Ang ◽  
Juliana Chen ◽  
Jolyn Johal ◽  
Jia Huan Liew ◽  
Yock Young Dan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Health Behavior ◽  
Weight Management ◽  
Weight Change ◽  
Meta Analysis ◽  
Asian Population ◽  
Health Behavior Change ◽  
Controlled Trials

BACKGROUND Smartphone applications (apps) have shown potential in enhancing weight management in the Western population in the short to medium term. With a rapidly growing obesity burden in the Asian populations, researchers are turning to apps as a service delivery platform to reach a greater target audience to efficiently tackle the problem. OBJECTIVE This systematic review and meta-analysis aimed to determine the efficacy of interventions incorporating apps in facilitating weight loss and health behavior change in the Asian population. METHODS Six databases were searched in June 2020. Eligible studies were controlled trials utilizing an app in the intervention in participants aged 18 years or above and from an Asian ethnicity. A meta-analysis to test intervention efficacy, subgroup analyses and post-hoc analyses were conducted to determine the effects of adding app to usual care and study duration. The primary outcome was absolute or percentage weight change while secondary outcomes were changes to lifestyle behaviors. RESULTS A total of 21 studies were included in this review and 17 were selected for the meta-analysis. The pooled effect size across 14 randomized controlled trials for weight change was small to moderate (Hedges’ g = -0.28, 95% CI = -0.44 to -0.12) however, this was not representative of long-term studies (more than a year). Stand-alone app interventions were inefficacious for weight loss but supplementing multi-component usual care with an app led to statistically significant weight change (Hedges’ g = -0.25 95% CI = -0.43 to -0.07). Asian apps were largely culturally adapted and multi-functional, with the most common app features being communication with health professionals and self-monitoring of behaviors and outcomes. CONCLUSIONS More evidence is required to determine the efficacy of apps in the long term and address app non-usage to maximize the potential of the intervention. Future research should determine the efficacy of each component of the multi-component intervention to facilitate study designs that are most effective and cost-efficient for weight management. CLINICALTRIAL PROSPERO REGISTRATION: CRD42020165240.

Mo1010 Maintenance of Long-Term Weight Loss With Intragastric Balloons – a Systematic Review and Meta-analysis

2016 ◽  
Vol 83 (5) ◽  
pp. AB425-AB426
Author(s):  
Violeta Popov ◽  
Allison Schulman ◽  
Christopher C. Thompson
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Meta Analysis ◽  
Intragastric Balloons

scholarly journals Optimising weight-loss interventions in cancer patients—A systematic review and network meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245794
Author(s):  
Nathalie LeVasseur ◽  
Wei Cheng ◽  
Sasha Mazzarello ◽  
Mark Clemons ◽  
Lisa Vandermeer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Cancer Patients ◽  
Standard Care ◽  
Meta Analysis ◽  
Lifestyle Interventions ◽  
Dietary Interventions ◽  
Anthropometric Measures ◽  
Combination Strategies ◽  
Diet And Exercise

Background Excess weight has been associated with increased morbidity and a worse prognosis in adult patients with early-stage cancer. The optimal lifestyle interventions to optimize anthropometric measures amongst cancer patients and survivors remain inconsistent. Objective To conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the effects of exercise and dietary interventions alone or in combination on anthropometric measures of adult cancer patients and survivors. Methods A systematic search of Medline, Embase and the Cochrane Trials Registry was performed. Outcomes of interest included changes in weight, body mass index (BMI), and waist circumference. Screening and data collection were performed by two reviewers. Bayesian NMAs were performed. Results Overall, 98 RCTs were included; 75 were incorporated in NMAs (n = 12,199). Groups of intervention strategies included: 3 exercise interventions, 8 dietary interventions, 7 combination interventions of diet and exercise and standard care. Median intervention duration was 26 weeks. NMA suggested that diet alone (mean difference [MD] -2.25kg, 95% CrI -3.43 to -0.91kg) and combination strategies (MD -2.52kg, 95% CrI -3.54 to -1.62kg) were associated with more weight loss compared to standard care. All dietary interventions achieved a similar magnitude of weight loss (MD range from -2.03kg to -2.52kg). Both diet alone and combination strategies demonstrated greater BMI reductions versus standard care, and each of diet alone, exercise alone and combination strategies demonstrated greater reductions in waist circumference than standard care. Conclusion Diet and exercise alone or in combination are effective lifestyle interventions to improve anthropometric measures in cancer patients and survivors. All reputable diets appear to be similarly effective to achieve weight loss.

scholarly journals Obesity and Mortality Among Patients Diagnosed With COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Tahmina Nasrin Poly ◽  
Md. Mohaimenul Islam ◽  
Hsuan Chia Yang ◽  
Ming Chin Lin ◽  
Wen-Shan Jian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Web Of Science ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Class Iii ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Class Iii Obesity

Coronavirus disease 2019 (COVID-19) has already raised serious concern globally as the number of confirmed or suspected cases have increased rapidly. Epidemiological studies reported that obesity is associated with a higher rate of mortality in patients with COVID-19. Yet, to our knowledge, there is no comprehensive systematic review and meta-analysis to assess the effects of obesity and mortality among patients with COVID-19. We, therefore, aimed to evaluate the effect of obesity, associated comorbidities, and other factors on the risk of death due to COVID-19. We did a systematic search on PubMed, EMBASE, Google Scholar, Web of Science, and Scopus between January 1, 2020, and August 30, 2020. We followed Cochrane Guidelines to find relevant articles, and two reviewers extracted data from retrieved articles. Disagreement during those stages was resolved by discussion with the main investigator. The random-effects model was used to calculate effect sizes. We included 17 articles with a total of 543,399 patients. Obesity was significantly associated with an increased risk of mortality among patients with COVID-19 (RRadjust: 1.42 (95%CI: 1.24–1.63, p &lt; 0.001). The pooled risk ratio for class I, class II, and class III obesity were 1.27 (95%CI: 1.05–1.54, p = 0.01), 1.56 (95%CI: 1.11–2.19, p &lt; 0.01), and 1.92 (95%CI: 1.50–2.47, p &lt; 0.001), respectively). In subgroup analysis, the pooled risk ratio for the patients with stroke, CPOD, CKD, and diabetes were 1.80 (95%CI: 0.89–3.64, p = 0.10), 1.57 (95%CI: 1.57–1.91, p &lt; 0.001), 1.34 (95%CI: 1.18–1.52, p &lt; 0.001), and 1.19 (1.07–1.32, p = 0.001), respectively. However, patients with obesity who were more than 65 years had a higher risk of mortality (RR: 2.54; 95%CI: 1.62–3.67, p &lt; 0.001). Our study showed that obesity was associated with an increased risk of death from COVID-19, particularly in patients aged more than 65 years. Physicians should aware of these risk factors when dealing with patients with COVID-19 and take early treatment intervention to reduce the mortality of COVID-19 patients.

scholarly journals Efficacy and safety of phentermine/topiramate in adults with overweight or obesity: A meta-analysis and systematic review

2020 ◽  
Author(s):  
Xiang-Guo Lei ◽  
Chen Lai ◽  
Ziyi Sun ◽  
Xi Yang
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Nervous System ◽  
Body Weight ◽  
Adverse Events ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Reduced Body

AbstractObjectiveTo examine the association between phentermine/topiramate therapy and weight loss and adverse events in adults with overweight problems or obesity by meta-analysis and systematic review.MethodsMedical Subject Headings (MeSH) and free-text terms related to phentermine/topiramate were selected to search for eligible trials in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE up to April 18, 2020. The quality of randomized controlled trials was evaluated by Cochrane risk-of-bias tool. Meta-analysis was performed using random-effect models. Our systematic review protocol, registered on PROSPERO (registration number CRD42020188324).ResultsPhentermine/topiramate therapy resulted in a weight loss of 7.73 kg (95% confidence interval [CI]: 6.60, 8.85) compared to placebo. For phentermine/topiramate subjects in different weight loss subgroups, the weight loss of subjects with ≥5%, ≥10%, and ≥15% baseline weight loss were 3.18 (95% CI: 2.75, 3.67), 5.32 (95% CI: 4.53, 6.25), and 5.65 (95% CI: 3.55, 9.01), respectively. Phentermine/topiramate reduced waist circumference, blood pressure, blood sugar levels, and lipid levels. The adverse effects associated with the treatment mainly included Dysgeusia, Paresthesia, Dry mouth.ConclusionsPhentermine/topiramate reduced body weight and was well tolerated. However, it increased the risk of nervous system-related adverse events to a certain extent, but the symptoms are not serious. Long-term clinical and pharmacological studies are needed to understand the long-term efficacy and safety of phentermine/topiramate.Study Importance QuestionsPhentermine/topiramate was approved by the FDA as an anti-obesity drug. However, the European Medicines Agency refused marketing authorization for phentermine/topiramate owing to safety concerns.Phentermine/topiramate reduced body weight and was well tolerated. However, it remarkably increased the risk of nervous system-related adverse events.In this study, the efficacy and incidence of adverse events of phentermine/topiramate were further evaluated through meta-analysis to provide reference for the clinical use of phentermine/topiramate.

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