Self-help for weight loss in overweight and obese adults: Systematic review and meta-analysis
Hartmann-Boyce J., Jebb SA., Fletcher BR., Aveyard P.
We conducted a systematicreviewandmeta-analysis investigating the components and effectiveness of self-help weight-lossinterventionsand their applicability to lessadvantaged populations.We searched (November 2013) for randomized controlled trials comparing selfhelp interventions with each other or with minimal controls in overweight and obese adults, with 6 months or longer follow-up. We calculated mean difference between intervention and control for 6-and 12-month weight change.Twenty-three studies met the inclusion criteria (9632 participants; 39 intervention arms). Intervention participants lost significantly more weight than controls at 6 months (mean difference-1.85 kg; 95% confidence interval [CI] =-2.86,-0.83; 7 studies). No significant effect was detected at 12months but results were sensitive to the inclusion of 1 study at high risk of bias. Interactive programs appeared more effective than standard ones at 6 months (mean difference-0.94 kg; 95% CI =-1.50,-0.38). Evidence is insufficient to reach conclusions on effectiveness in socioeconomically disadvantaged people, but suggests self-help interventions may be less effective in this group.