BACKGROUND: Lifestyle interventions are effective for weight loss and are recommended for persons with a body mass index (BMI) of 25-40 kg m(-2). However, this group is very heterogeneous, which could influence outcomes from lifestyle interventions. PURPOSE: In this systematic review, differences in 1-year weight change and percentage weight change after lifestyle interventions were investigated for participants varying in initial BMI using meta-analyses. METHOD: Twenty-two interventions with healthy Caucasian adults, a mean BMI between 25 and 40 kg m(-2), a dietary as well as a physical activity component aiming at weight loss, and at least five contact sessions guided by a professional health care provider were selected from a systematic search in the MEDLINE database. Participants in each intervention were divided into one of the three BMI classes: overweight (BMI of 25-29.99 kg m(-2)), class-I obesity (BMI of 30-34.99 kg m(-2)), and class-II obesity (BMI of 35-39.99 kg m(-2)). Differences in weight change and percentage weight change were analyzed and compared among different BMI classes within the same intervention by calculating standardized mean differences. RESULTS: Overweight participants lost 1.1 kg less (p < 0.01) than participants with class-I obesity and 1.5 kg less (p < 0.01) than participants with class-II obesity. For percentage weight change, no significant differences were found among the BMI classes. CONCLUSION: Average weight change during lifestyle interventions only differs to a small extent among people with BMI between 25 and 40 kg m(-2). This implies that these interventions are equally appropriate for these BMI classes.
BACKGROUND: Lifestyle interventions are effective for weight loss and are recommended for persons with a body mass index (BMI) of 25-40 kg m(-2). However, this group is very heterogeneous, which could influence outcomes from lifestyle interventions. PURPOSE: In this systematic review, differences in 1-year weight change and percentage weight change after lifestyle interventions were investigated for participants varying in initial BMI using meta-analyses. METHOD: Twenty-two interventions with healthy Caucasian adults, a mean BMI between 25 and 40 kg m(-2), a dietary as well as a physical activity component aiming at weight loss, and at least five contact sessions guided by a professional health care provider were selected from a systematic search in the MEDLINE database. Participants in each intervention were divided into one of the three BMI classes: overweight (BMI of 25-29.99 kg m(-2)), class-I obesity (BMI of 30-34.99 kg m(-2)), and class-II obesity (BMI of 35-39.99 kg m(-2)). Differences in weight change and percentage weight change were analyzed and compared among different BMI classes within the same intervention by calculating standardized mean differences. RESULTS: Overweight participants lost 1.1 kg less (p < 0.01) than participants with class-I obesity and 1.5 kg less (p < 0.01) than participants with class-II obesity. For percentage weight change, no significant differences were found among the BMI classes. CONCLUSION: Average weight change during lifestyle interventions only differs to a small extent among people with BMI between 25 and 40 kg m(-2). This implies that these interventions are equally appropriate for these BMI classes.
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