Photo Credit: Maryna Auramchuk
Although long-term diet and exercise improvement is the gold standard in obesity treatment, weight loss can also be achieved during short-term interventions.
Long-term diet and exercise interventions are ideal for patients who are overweight or obese. Studies have shown, however, that maintaining lifestyle changes over a lengthy period is challenging for most patients.
Short-term nutritional and physical activity regimens have received little scrutiny in the shadow of the preferred permanent lifestyle adjustments. Given the limited success rate of long-term diet and exercise alteration, examining the potential health benefits of short-term improvements from a healthcare perspective could be beneficial.
Short Duration
Wendi Rotunda, PhD, and colleagues conducted a literature review of articles covering lifestyle change interventions with durations of 6 months or less. They included randomized-controlled trials involving patients who were obese or overweight. The authors published the review’s findings in Preventing Public Disease: Public Health Research, Practice, and Policy.
“Although weight loss is associated with preventing or delaying the onset of chronic conditions, long-term interventions have challenges in enrolling and retaining participants,” Dr. Rotunda and colleagues explained. “We sought to understand the extent to which multicomponent interventions of 6 months or less were effective at achieving weight loss among adults with overweight or obesity.”
The team searched Medline, Web of Science, APA PsycInfo, Embase, CINAHL, and Cochrane Library and identified 1,251 relevant articles. Of these, 14 randomized controlled trials (RCT) met the review’s inclusion criteria.
Most studies focused on improved diet and increased physical activity, with two only focusing on diet. The specifics of diet adjustment varied between studies, with some targeting caloric intake and one incorporating a specialized diet. More than one intervention was present in each study, including in-person information sessions, website diet trackers, website exercise trackers, educational resources, financial incentives, tools such as scales and pedometers, and follow-ups.
Weight Change
Across all included studies, the collective mean difference for weight change was less than −2.59 kg (95% CI, −3.47 to −1.72; 14 RCTs with 2,407 participants; I2 = 69%). The negative difference shows that participants in the intervention groups lost more weight than the comparison groups.
In the shorter studies (ie, those lasting less than 13 weeks), the collective mean difference for weight change was −2.70 kg (95% CI, −3.69 to −1.71; 7 RCTs with 1,051 participants, I2 = 73%).
In the longer studies (ie, those lasting 13-26 weeks), the collective mean difference for weight change was −2.40 kg (95% CI, −4.44 to −0.37; 7 RCTs with 1,356 participants; I2 = 69%).
“Our findings may have important health implications. Although the mean difference of approximately 2 kg among participants in the lifestyle change interventions relative to controls is modest, it can be clinically meaningful,” the authors wrote.
The researchers conducted a moderator analysis of intervention duration, which resulted in a significant difference based on intervention duration (P=0.046). The data had significant heterogeneity overall and when ranked according to intervention duration.
“A key contribution of our study is bolstering the evidence that short-term lifestyle change interventions may result in weight change benefits in adults with overweight or obesity and could provide an alternative to longer interventions that some people may be unable or unwilling to complete,” Dr. Rotunda and colleagues concluded.
“Additional research may be needed to disentangle the intervention components that drive weight change for interventions of shorter durations, such as the type of dietary guidance or the frequency and nature of physical activity recommendations. Additionally, future work should explore how social determinants of health, such as access to affordable and quality healthy food or safe places for physical activity, affect program and health outcomes.”
