Self-directed interventions to promote weight loss: a systematic review and meta-analysis

TY - JOUR

T1 - Self-directed interventions to promote weight loss

T2 - a systematic review and meta-analysis

AU - Tang, Jason C H

AU - Abraham, Charles

AU - Greaves, Colin J.

AU - Nikolaou, Vasilis

N1 - The work was partially funded by the UK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC) and partly by the NIHR Career Development Fellowship CDF-2012-05-259.

PY - 2016/7/2

Y1 - 2016/7/2

N2 - Many self-directed weight-loss interventions have been developed using a variety of delivery formats (e.g., internet and smartphone) and change techniques. Yet, little research has examined whether self-directed interventions can exclusively promote weight loss. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library were systematically reviewed for randomised controlled trials evaluating self-directed interventions in relation to weight-loss outcomes in adults. Standardised mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random effects model. Twenty-seven trials incorporating 36 comparisons met our inclusion criteria. Participants using self-directed interventions lost significantly more weight (MD= −1.56 kg, CI −2.25, −0.86 ranging from 0.6 to 5.3 kg) compared to those in the minimal intervention or no-treatment groups (3.1-month follow-up median). The majority of interventions were internet based (18 evaluations) and these were effective at 3 months (MD = −1.74 kg, CI −2.65, −0.82 ranging from 0.6 to 4.8 kg) (SMD = −0.48, 95% CI −0.72, −0.24, I2 = 82%; p 2 = 76%; p =.004; 4 evaluations). Self-directed weight-loss interventions can generate modest weight loss for up to 6 months but may need to be supplemented by other interventions to achieve sustained and clinically meaningful weight loss.

AB - Many self-directed weight-loss interventions have been developed using a variety of delivery formats (e.g., internet and smartphone) and change techniques. Yet, little research has examined whether self-directed interventions can exclusively promote weight loss. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library were systematically reviewed for randomised controlled trials evaluating self-directed interventions in relation to weight-loss outcomes in adults. Standardised mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random effects model. Twenty-seven trials incorporating 36 comparisons met our inclusion criteria. Participants using self-directed interventions lost significantly more weight (MD= −1.56 kg, CI −2.25, −0.86 ranging from 0.6 to 5.3 kg) compared to those in the minimal intervention or no-treatment groups (3.1-month follow-up median). The majority of interventions were internet based (18 evaluations) and these were effective at 3 months (MD = −1.74 kg, CI −2.65, −0.82 ranging from 0.6 to 4.8 kg) (SMD = −0.48, 95% CI −0.72, −0.24, I2 = 82%; p 2 = 76%; p =.004; 4 evaluations). Self-directed weight-loss interventions can generate modest weight loss for up to 6 months but may need to be supplemented by other interventions to achieve sustained and clinically meaningful weight loss.

KW - eHealth

KW - meta-analysis

KW - obesity

KW - self-delivered intervention

KW - systematic review

KW - Weight loss

UR - https://www.scopus.com/pages/publications/84982985770

U2 - 10.1080/17437199.2016.1172979

DO - 10.1080/17437199.2016.1172979

M3 - Review article

C2 - 27091296

AN - SCOPUS:84982985770

SN - 1743-7199

VL - 10

SP - 358

EP - 372

JO - Health Psychology Review

JF - Health Psychology Review

IS - 3

ER -