What interventions should we add to weight reducing diets in adults with obesity? A systematic review of randomized controlled trials of adding drug therapy, exercise, behaviour therapy or combinations of these interventions
Background Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy. Methods We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials...
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| Published in | Journal of human nutrition and dietetics Vol. 17; no. 4; pp. 293 - 316 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Science Ltd
01.08.2004
Blackwell Science Blackwell Publishing Ltd |
| Subjects | |
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| Abstract | Background Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy.
Methods We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed.
Results Adding orlistat to diet was associated with weight change for up to 24 months (−3.26 kg, 95% CI, −4.15 to −2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of −4.18 kg (95% CI, −5.14 to −3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure.
Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change.
Conclusions Adding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long‐term weight loss. |
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| AbstractList | Background Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy.
Methods We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed.
Results Adding orlistat to diet was associated with weight change for up to 24 months (−3.26 kg, 95% CI, −4.15 to −2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of −4.18 kg (95% CI, −5.14 to −3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure.
Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change.
Conclusions Adding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long‐term weight loss. Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy. We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed. Adding orlistat to diet was associated with weight change for up to 24 months (-3.26 kg, 95% CI, -4.15 to -2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of -4.18 kg (95% CI, -5.14 to -3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure. Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change. Adding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long-term weight loss. Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy.BACKGROUNDEvidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy.We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed.METHODSWe systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed.Adding orlistat to diet was associated with weight change for up to 24 months (-3.26 kg, 95% CI, -4.15 to -2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of -4.18 kg (95% CI, -5.14 to -3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure. Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change.RESULTSAdding orlistat to diet was associated with weight change for up to 24 months (-3.26 kg, 95% CI, -4.15 to -2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of -4.18 kg (95% CI, -5.14 to -3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure. Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change.Adding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long-term weight loss.CONCLUSIONSAdding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long-term weight loss. Background Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy. Methods We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed. Results Adding orlistat to diet was associated with weight change for up to 24 months (−3.26 kg, 95% CI, −4.15 to −2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of −4.18 kg (95% CI, −5.14 to −3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure. Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change. Conclusions Adding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long‐term weight loss. |
| Author | Campbell, M. K. McGee, M. A. Grant, A. M. Smith, W. C. S. Jung, R. T. Broom, J. Avenell, A. Brown, T. J. |
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| Publisher | Blackwell Science Ltd Blackwell Science Blackwell Publishing Ltd |
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(e_1_2_45_62_1) 1987; 11 e_1_2_45_44_1 e_1_2_45_65_1 Jones S.E. (e_1_2_45_29_1) 1986; 40 e_1_2_45_21_1 e_1_2_45_9_1 e_1_2_45_48_1 e_1_2_45_25_1 e_1_2_45_46_1 e_1_2_45_67_1 Wadden T.A. (e_1_2_45_61_1) 1986; 54 e_1_2_45_40_1 Broom I. (e_1_2_45_11_1) 2002; 56 Anderssen S.A. (e_1_2_45_3_1) 1995; 5 Kelley D. (e_1_2_45_33_1) 1997; 5 Mathias S. (e_1_2_45_39_1) 1997; 5 Jones S.P. (e_1_2_45_30_1) 1995; 19 e_1_2_45_18_1 Broom I. (e_1_2_45_10_1) 2001; 25 e_1_2_45_32_1 e_1_2_45_53_1 e_1_2_45_13_1 James W.P. (e_1_2_45_27_1) 1997; 21 e_1_2_45_59_1 e_1_2_45_15_1 e_1_2_45_34_1 Phenix A. (e_1_2_45_45_1) 1990 e_1_2_45_57_1 Long C.G.S. (e_1_2_45_38_1) 1983; 37 e_1_2_45_72_1 e_1_2_45_70_1 Clarke M. (e_1_2_45_12_1) 2002 e_1_2_45_5_1 Department of Health (e_1_2_45_14_1) 2003 Hauptman J. (e_1_2_45_23_1) 1999; 7 Lindgarde F. (e_1_2_45_36_1) 1999; 7 e_1_2_45_20_1 e_1_2_45_43_1 e_1_2_45_66_1 Wilding J. (e_1_2_45_69_1) 2001; 25 e_1_2_45_22_1 e_1_2_45_41_1 Foreyt J.P. (e_1_2_45_19_1) 1997; 5 e_1_2_45_24_1 e_1_2_45_47_1 Farrell J. (e_1_2_45_16_1) 1997; 5 Smith I.G. (e_1_2_45_54_1) 1997; 5 e_1_2_45_26_1 e_1_2_45_68_1 e_1_2_45_8_1 e_1_2_45_60_1 Smith I.G. (e_1_2_45_55_1) 2001; 50 Wadden T.A. (e_1_2_45_63_1) 1988; 56 e_1_2_45_17_1 Ashutosh K. (e_1_2_45_7_1) 1997; 37 World Health Organization (e_1_2_45_76_1) 2000 Sikand G. (e_1_2_45_51_1) 1988; 88 |
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| Snippet | Background Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy.... Background Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy.... Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy. We... Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour... |
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| SubjectTerms | Adult Anti-Obesity Agents - therapeutic use Behavior Therapy behaviour therapy Biological and medical sciences Blood Pressure - drug effects Blood Pressure - physiology Combined Modality Therapy Diet, Fat-Restricted Diet, Reducing drug therapy Evidence-Based Medicine Exercise Female Humans Lipid Metabolism Male Medical sciences Middle Aged Miscellaneous obesity Obesity - diet therapy Obesity - drug therapy Obesity - therapy Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) randomized controlled trials Randomized Controlled Trials as Topic systematic review Treatment Outcome Weight Loss - drug effects Weight Loss - physiology |
| Title | What interventions should we add to weight reducing diets in adults with obesity? A systematic review of randomized controlled trials of adding drug therapy, exercise, behaviour therapy or combinations of these interventions |
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