Abstract
Background
Obesity is associated with a multitude of comorbidities and considerable health care costs.
Objective
The objective of this review was to examine the efficacy of weight management interventions provided by a registered dietitian or international equivalent (referred to as “dietitian”).
Methods
This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of weight management interventions provided by a dietitian, compared with usual care or no intervention, on several cardiometabolic outcomes and quality of life in adults with overweight or obesity. MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and CINAHL databases were searched for eligible RCTs published between January 2008 and January 2021 in the English language. Meta-analyses were conducted using a random-effects model, publication bias was assessed using funnel plots and Egger’s statistics, and heterogeneity was assessed by interpreting I2 values. Efficacy of intervention components, such as telehealth or group contacts, were explored in sub-group analyses. Version 2 of the risk-of-bias tool for RCTs was used to assess risk of bias. The Grading of Recommendations Assessment, Development and Evaluation method was used to determine certainty of evidence.
Results
This systematic review included 62 RCTs. Compared with control conditions, weight management interventions provided by a dietitian resulted in improved body mass index (mean difference [MD] –1.5; 95% CI –1.74 to –1.26; moderate evidence certainty); percent weight loss (MD –4.01%; 95% CI –5.26% to –2.75%; high evidence certainty); waist circumference (MD –3.45 cm; 95% CI –4.39 to –2.51 cm; high evidence certainty); blood pressure (MD –3.04 mm Hg; 95% CI –5.10 to –0.98 mm Hg and MD –1.99 mm Hg; 95% CI –3.02 to –0.96 mm Hg for systolic blood pressure and diastolic blood pressure, respectively; moderate and low evidence certainty); and quality of life using the 36-Item Short Form Survey (MD 5.84; 95% CI 2.27 to 9.41 and 2.39; 95% CI 1.55 to 3.23 for physical and mental quality of life, respectively; low and moderate evidence certainty).
Conclusions
For adults with overweight or obesity, weight management interventions provided by a dietitian are efficacious for improving several examined cardiometabolic outcomes and quality of life.
【저자키워드】 obesity, systematic review, overweight, Nutrition therapy, Dietitian, 【초록키워드】 Randomized controlled trial, Meta-analysis, Efficacy, survey, Comorbidity, Intervention, outcome, database, heterogeneity, RCT, body mass index, Health, management, International, Risk of bias, Quality of life, assessment, development, Care, moderate, RCTs, cardiometabolic, Evidence, blood pressure, English language, weight loss, Diastolic blood pressure, Systolic blood pressure, Waist circumference, 95% CI, usual care, components, CINAHL, PsycINFO, Registered, Version, mean difference, random-effects model, funnel plot, Mental, objective, physical, Cochrane Central, Result, was used, examined, form, conducted, provided, searched, determine, analyses, conditions, certainty of evidence, eligible, 【제목키워드】 review, weight, center,