The Effectiveness of Nonsurgical Interventions for Weight Loss Maintenance in Adults: An Updated, Grade-Assessed Systematic Review and Meta-Analysis of Randomized Clinical Trials Publisher Pubmed



Ghoreishy SM^{1, 2} ; Noormohammadi M^{1, 2} ; Zeraattalabmotlagh S³ ; Shoaibinobarian N⁴ ; Rashedi MH² ; Movahed S⁴ ; Hemmati A⁵ ; Nazarian A² ; Fernandez ML⁶ ; Shidfar F²
Source: Nutrition Reviews Published:2025

Abstract

Context: Today, there are many discussions about the best way to maintain weight and prevent weight regain after a period of weight loss. Objectives: The aim of this study was to summarize, based on data from randomized clinical trials (RCTs), the impact of nonsurgical interventions for adults’ weight loss maintenance. Data Sources: The Medline (PubMed), Scopus, and Web of Science databases were reviewed during June 2023. Data Extraction: Meta-analyses assessing the impacts of nonsurgical interventions for weight loss maintenance were conducted. Effect sizes of nutritional interventions were recalculated by applying a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluation framework was implemented to determine evidence certainty. Results: Meta-analysis of data from a total of 56 RCTs (n ¼ 13 270 participants) represented a significant weight reduction after behavior and lifestyle interventions (mean difference [MD], –0.64 kg [95% CI, –1.18 to –0.09]; I2 ¼ 89.5%; P < .001 for heterogeneity). Pharmacological interventions had also a significant effect on weight change during the weight maintenance phase (MD, –2.57 kg [95% CI, –3.12 to –2.02]; I2 ¼ 91.6%; P < .001 for heterogeneity). The weight loss reduction from pharmacological interventions was greater with sibutramine (MD, –2.57; 95% CI: –3.12 to –2.02). Additionally, diet intervention and dietary and physical activity strategies were associated with a negligible trending decrease in weigh regain (respectively: MD, –0.91 kg [95% CI, –2.18 to 0.36], I2 ¼ 55.7%, P ¼ .016 for heterogeneity; and MD, –0.3 kg [95% CI, –4.13 to 3.52], I2 ¼ 94.1%, P < .001). Conclusion: The findings of this review indicate there is a favorable impact of behavior-based interventions and antiobesity medications on weight maintenance. Systematic Review Registration: PROSPERO registration no CRD42023468056. © The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved.