Prevention and treatment of obesity with lifestyle interventions: review and meta-analysis

Summary Objective: To assess the mid- to long-term effectiveness of lifestyle interventions in the prevention and treatment of obesity. Methods: A systematic literature review with meta-analysis was performed. Electronic databases, reference lists, books and reports covering topic of obesity were searched. The included studies were randomized clinical trials of lifestyle interventions in overweight and obese subjects that had a minimum observation period of one year. Outcomes evaluated were measurements of body weight, body mass index, waist circumference, systolic and diastolic blood pressure, blood lipids: total cholesterol, low density lipoprotein, high density lipoprotein, triglyceride, blood glucose control: two-hour plasma glucose, fasting plasma glucose, and glycosylated haemoglobin. Results: Thirteen studies have been selected in the prevention and seventeen in the treatment of obesity. Compared with standard care, lifestyle intervention reduced significantly body weight, body mass index, waist circumference, blood pressure, blood lipids and blood glucose in overweight and obese people. The favorable effects were maintained up to three years. Conclusions: Lifestyle interventions were efficacious in the mid- to long-term prevention and treatment of obesity leading to a significant reduction in body weight and cardiovascular risk factors. Submitted: 18 October 2006; Revised: 6 June 2007; Accepted: 28 August 2007