Evidence map›Paper›PMID 34404631›Full record

SynthesisBMJ (Clinical research ed.)2021

Association between characteristics of behavioural weight loss programmes and weight change after programme end: systematic review and meta-analysis.

Jamie Hartmann-Boyce, Annika Theodoulou, Jason L Oke, Ailsa R Butler, Peter Scarborough, Anastasios Bastounis, Anna Dunnigan, Rimu Byadya, F D Richard Hobbs, Falko F Sniehotta and 2 more

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07476599 (The OB-WELL Project), which is not on this map. Cited by 31 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07476599 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The OB-WELL Project: Study Protocol for a Three-Arm Randomized Controlled Trial of an Internet-Based Self-Help System for Psychological Support in Obesity

TypeinterventionalSponsorCatholic University of the Sacred HeartRan2026 to 2027Enrolled224ConditionsObesity (BMI > 35)ArmsBST Internet-based intervention, CBT Internet-based intervention
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jamie Hartmann-BoyceNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK jamie.hartmann-boyce@phc.ox.ac.uk.ORCID 0000-0001-9898-3049
Annika TheodoulouNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Jason L OkeNIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Ailsa R ButlerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Peter ScarboroughOxford Biomedical Research Centre, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford, UK.
Anastasios BastounisNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Anna DunniganRoyal Free Hospital, Royal Free London NHS Foundation Trust, London, UK.
Rimu ByadyaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
F D Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Falko F SniehottaFaculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Susan A JebbNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Paul AveyardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-1802-4217

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine if the characteristics of behavioural weight loss programmes influence the rate of change in weight after the end of the programme.

designSystematic review and meta-analysis. DATA SOURCES: Trial registries, 11 electronic databases, and forward citation searching (from database inception; latest search December 2019). Randomised trials of behavioural weight loss programmes in adults with overweight or obesity, reporting outcomes at ≥12 months, including at the end of the programme and after the end of the programme. REVIEW

methodsStudies were screened by two independent reviewers with discrepancies resolved by discussion. 5% of the studies identified in the searches met the inclusion criteria. One reviewer extracted the data and a second reviewer checked the data. Risk of bias was assessed with Cochrane's risk of bias tool (version 1). The rate of change in weight was calculated (kg/month; converted to kg/year for interpretability) after the end of the programme in the intervention versus control groups by a mixed model with a random intercept. Associations between the rate of change in weight and prespecified variables were tested.

resultsData were analysed from 249 trials (n=59 081) with a mean length of follow-up of two years (longest 30 years). 56% of studies (n=140) had an unclear risk of bias, 21% (n=52) a low risk, and 23% (n=57) a high risk of bias. Regain in weight was faster in the intervention versus the no intervention control groups (0.12-0.32 kg/year) but the difference between groups was maintained for at least five years. Each kilogram of weight lost at the end of the programme was associated with faster regain in weight at a rate of 0.13-0.19 kg/year. Financial incentives for weight loss were associated with faster regain in weight at a rate of 1-1.5 kg/year. Compared with programmes with no meal replacements, interventions involving partial meal replacements were associated with faster regain in weight but not after adjustment for weight loss during the programme. Access to the programme outside of the study was associated with slower regain in weight. Programmes where the intensity of the interaction reduced gradually were also associated with slower regain in weight in the multivariable analysis, although the point estimate suggested that the association was small. Other characteristics did not explain the heterogeneity in regain in weight.

conclusionFaster regain in weight after weight loss was associated with greater initial weight loss, but greater initial weight loss was still associated with reduced weight for at least five years after the end of the programme, after which data were limited. Continued availability of the programme to participants outside of the study predicted a slower regain in weight, and provision of financial incentives predicted faster regain in weight; no other clear associations were found. STUDY REGISTRATION: PROSPERO CRD42018105744.

Indexed as

Body-Weight TrajectoryAdultBehavior TherapyFemaleHumansMaleMiddle AgedObesityOverweightProgram EvaluationRandomized Controlled Trials as TopicTreatment OutcomeWeight LossWeight Reduction Programs

Identifiers

PMID34404631
PMCPMC8369384

What Socratic holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.