Abstract
Background
Adhering to weight loss interventions is difficult for many people. The majority of those who are overweight or obese and attempt to lose weight are simply not successful. The objectives of this study were 1) to quantify overall adherence rates for various weight loss interventions and 2) to provide pooled estimates for factors associated with improved adherence to weight loss interventions.
Methods
We performed a systematic literature review and meta-analysis of all studies published between January 2004 and August 2015 that reviewed weight loss intervention adherence.
Results
After applying inclusion and exclusion criteria and checking the methodological quality, 27 studies were included in the meta-analysis. The overall adherence rate was 60.5% (95% confidence interval [CI] 53.6–67.2). The following three main variables were found to impact adherence: 1) supervised attendance programs had higher adherence rates than those with no supervision (rate ratio [RR] 1.65; 95% CI 1.54–1.77); 2) interventions that offered social support had higher adherence than those without social support (RR 1.29; 95% CI 1.24–1.34); and 3) dietary intervention alone had higher adherence than exercise programs alone (RR 1.27; 95% CI 1.19–1.35).
Conclusion
A substantial proportion of people do not adhere to weight loss interventions. Programs supervising attendance, offering social support, and focusing on dietary modification have better adherence than interventions not supervising attendance, not offering social support, and focusing exclusively on exercise.
Supplementary materials
Search terms
Weight loss programs
Weight loss intervention
Weight loss regimen
Weight loss plan
Weight reduction programs
Weight reduction intervention
Weight reduction regimen
Weight reduction plan
Adherence
Behavior modification
Search strategy
(((((((((Weight loss programs) OR weight loss intervention) OR weight loss regimen) OR weight loss plan) OR weight reduction programs) OR weight reduction intervention) OR weight reduction regimen) OR weight reduction plan)) AND ((adherence) OR “behavior modification”).
Databases searched
Medline
PubMed
Cochrane Library
CINAHL
Global Health
ISI Web of Knowledge
ProQuest
SCOPUS
EMBASE
Inclusion criteria
Article should be in English language.
Article should have a prospective design.
Article should have quantifiable data describing the effect size.
Article should describe participation in a supervised weight loss program that is neither pharmacologic nor surgical and assess adherence to the said program.
Article is publicly available.
Disclosure
The authors report no conflicts of interest in this work.