Long term maintenance of weight loss with non-surgical interventions in obese adults

Objective: To systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults and to assess the evidence for the effectiveness of these interventions.

Results: 45 trials involving 7788 individuals were included. Behavioural interventions focusing on both food intake and physical activity resulted in an average difference of -1.56 kg in weight regain compared with controls at 12 months. Orlistat combined with behavioural interventions resulted in a -1.80 kg difference compared with placebo at 12 months. All orlistat studies reported higher frequencies of adverse gastrointestinal events in the experimental compared with placebo control groups. A dose-response relation for orlistat treatment was found, with 120 mg doses three times a day leading to greater weight loss maintenance compared with 60 mg and 30 mg three times a day, P=0.02.

Conclusions: Behavioural interventions that deal with both diet and physical activity show small but significant benefits on weight loss maintenance.