TOPLINE:
Successful long-term weight control requires sustained changes in behaviour that are unlikely to be achieved by short-term pharmacological and dietary interventions alone. Self-monitoring and goal setting are the two most common techniques included in behavioural interventions for obesity, but they may be most effective when combined with other techniques such as problem solving and coping strategies. Behavioural interventions may yield modest effects in people with severe obesity, but the evidence base for this population is especially limited.
METHODOLOGY:
- An analysis of 22 reviews on behaviour change techniques (BCTs) for weight loss in adults with obesity.
TAKEAWAY:
- Self-monitoring was the most commonly reported technique among 17 reviews, with 43% of studies reporting a statistically significant weight loss compared with control individuals, although the exact amount of weight was not specified in the review.
- The use of mobile app self-monitoring resulted in a mean of 1.78 kg weight loss compared with control individuals, and digital self-monitoring through web or mobile apps resulted in a pooled weight loss of 2.87 kg vs control individuals.
- Digital interventions tailored to the individual showed a mean weight loss of 4.49 kg, but the meta-analyses did not report results in a defined follow-up period.
- Goal setting was commonly used in combination with other techniques in interventions, with one review showing weight loss up to 4.9 kg when it was combined with self-monitoring.
- For adults with severe obesity (body mass index > 35 kg/m2), one review found that "nudge" techniques led to a pooled 1.19 kg weight loss, with a stronger effect in men than in women.
IN PRACTICE:
"As with most research in the field of obesity, short-term studies are of limited value, and there is a need to evaluate the long-term impact of behavioural interventions," the authors wrote. "With the increasing use of patient groups to deliver care by health services, we suggest that this is an urgent priority for research," they added.
SOURCE:
Conducted by Lily K. Hawkins, of the Faculty of Health and Life Sciences, University of Exeter, Exeter, UK, and colleagues, this study was published online on July 1, 2024, in Obesity Reviews.
LIMITATIONS:
Few reviews considered the impact of BCTs on people with severe obesity. Study populations were predominantly White women aged 40-60 years. The lack of clear reporting practices hampered understanding of causal effects and specific BCT use. Few reviews reported the long-term effects of BCTs and those that did often reported a small or non-significant effect on weight loss at long-term follow-up. The review was time-limited and rapid.
DISCLOSURES:
This work was funded by the National Institute for Health and Care Research and the Applied Research Collaboration South West Peninsula. The authors have no conflicts of interest.
