Marco Solmi1, Cristiano A Köhler2, Brendon Stubbs3,4,5, Ai Koyanagi6,7, Beatrice Bortolato8, Francesco Monaco1, Davy Vancampfort9,10, Myrela O Machado2, Michael Maes11,12, Ioanna Tzoulaki13,14,15, Joseph Firth16,17, John P A Ioannidis18,19,20,21, André F Carvalho22,23. 1. Department of Neurosciences, University of Padova, Padova, Italy. 2. Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil. 3. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. 4. Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 5. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. 6. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain. 7. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain. 8. Department of Mental Health ULSS 10 "Veneto Orientale", Venice, Italy. 9. Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium. 10. University Psychiatric Centre, KU Leuven, University of Leuven, Leuven-Kortenberg, Belgium. 11. Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 12. IMPACT Strategic Research Center, Deakin University, Geelong, Vic., Australia. 13. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. 14. MRC-PHE Centre for Environment, School of Public Health, Imperial College London, London, UK. 15. Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece. 16. NICM, School of Science and Health, University of Western Sydney, Sydney, NSW, Australia. 17. Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. 18. Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California. 19. Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California. 20. Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California. 21. Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, California. 22. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. 23. Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada.
Abstract
BACKGROUND: Multiple environmental factors have been implicated in obesity, and multiple interventions, besides drugs and surgery, have been assessed in obese patients. Results are scattered across many studies and meta-analyses, and they often mix obese and overweight individuals. MATERIALS AND METHODS: PubMed and Cochrane Database of Systematic Reviews were searched through 21 January 2017 for meta-analyses of cohort studies assessing environmental risk factors for obesity, and randomized controlled trials investigating nonpharmacological and nonsurgical therapeutic interventions for obesity. We excluded data on overweight participants. Evidence from observational studies was graded according to criteria that included the statistical significance of the random-effects summary estimate and of the largest study in a meta-analysis, the number of obesity cases, heterogeneity between studies, 95% prediction intervals, small-study effects and excess significance. The evidence of intervention studies for obesity was assessed with the GRADE framework. RESULTS: Fifty-four articles met eligibility criteria, including 26 meta-analyses of environmental risk factors (166 studies) and 46 meta-analyses of nondrug, nonsurgical interventions (206 trials). In adults, the only risk factor with convincing evidence was depression, and childhood obesity, adolescent obesity, childhood abuse and short sleep duration had highly suggestive evidence. Infancy weight gain during the first year of life, depression and low maternal education had convincing evidence for association with paediatric obesity. All interventions had low or very-low-quality evidence with one exception of moderate-quality evidence for one comparison (no differences in efficacy between brief lifestyle primary care interventions and other interventions for paediatric obesity). Summary effect sizes were mostly small across compared interventions (maximum 5.1 kg in adults and 1.78 kg in children) and even these estimates may be inflated. CONCLUSIONS: Depression, obesity in earlier age groups, short sleep duration, childhood abuse and low maternal education have the strongest support among proposed risk factors for obesity. Furthermore, there is no high-quality evidence to recommend treating obesity with a specific nonpharmacological and nonsurgical intervention among many available, and whatever benefits in terms of magnitude of weight loss appear small.
BACKGROUND: Multiple environmental factors have been implicated in obesity, and multiple interventions, besides drugs and surgery, have been assessed in obesepatients. Results are scattered across many studies and meta-analyses, and they often mix obese and overweight individuals. MATERIALS AND METHODS: PubMed and Cochrane Database of Systematic Reviews were searched through 21 January 2017 for meta-analyses of cohort studies assessing environmental risk factors for obesity, and randomized controlled trials investigating nonpharmacological and nonsurgical therapeutic interventions for obesity. We excluded data on overweight participants. Evidence from observational studies was graded according to criteria that included the statistical significance of the random-effects summary estimate and of the largest study in a meta-analysis, the number of obesity cases, heterogeneity between studies, 95% prediction intervals, small-study effects and excess significance. The evidence of intervention studies for obesity was assessed with the GRADE framework. RESULTS: Fifty-four articles met eligibility criteria, including 26 meta-analyses of environmental risk factors (166 studies) and 46 meta-analyses of nondrug, nonsurgical interventions (206 trials). In adults, the only risk factor with convincing evidence was depression, and childhood obesity, adolescent obesity, childhood abuse and short sleep duration had highly suggestive evidence. Infancy weight gain during the first year of life, depression and low maternal education had convincing evidence for association with paediatric obesity. All interventions had low or very-low-quality evidence with one exception of moderate-quality evidence for one comparison (no differences in efficacy between brief lifestyle primary care interventions and other interventions for paediatric obesity). Summary effect sizes were mostly small across compared interventions (maximum 5.1 kg in adults and 1.78 kg in children) and even these estimates may be inflated. CONCLUSIONS:Depression, obesity in earlier age groups, short sleep duration, childhood abuse and low maternal education have the strongest support among proposed risk factors for obesity. Furthermore, there is no high-quality evidence to recommend treating obesity with a specific nonpharmacological and nonsurgical intervention among many available, and whatever benefits in terms of magnitude of weight loss appear small.
Authors: Elena Dragioti; Joaquim Radua; Marco Solmi; Celso Arango; Dominic Oliver; Samuele Cortese; Peter B Jones; Jae Il Shin; Christoph U Correll; Paolo Fusar-Poli Journal: Mol Psychiatry Date: 2022-04-28 Impact factor: 15.992
Authors: Angelique F Ralph; Leah Brennan; Sue Byrne; Belinda Caldwell; Jo Farmer; Laura M Hart; Gabriella A Heruc; Sarah Maguire; Milan K Piya; Julia Quin; Sarah K Trobe; Andrew Wallis; A J Williams-Tchen; Phillipa Hay Journal: J Eat Disord Date: 2022-08-18
Authors: Joseph Firth; Wolfgang Marx; Sarah Dash; Rebekah Carney; Scott B Teasdale; Marco Solmi; Brendon Stubbs; Felipe B Schuch; André F Carvalho; Felice Jacka; Jerome Sarris Journal: Psychosom Med Date: 2019-04 Impact factor: 4.312
Authors: Marco Solmi; Joaquim Radua; Brendon Stubbs; Valdo Ricca; Davide Moretti; Daniele Busatta; Andre F Carvalho; Elena Dragioti; Angela Favaro; Alessio Maria Monteleone; Jae Il Shin; Paolo Fusar-Poli; Giovanni Castellini Journal: Braz J Psychiatry Date: 2020-09-28 Impact factor: 2.697
Authors: Perrine Janiaud; Arnav Agarwal; Ioanna Tzoulaki; Evropi Theodoratou; Konstantinos K Tsilidis; Evangelos Evangelou; John P A Ioannidis Journal: BMC Med Date: 2021-07-06 Impact factor: 11.150