MANAGEMENT OF OVERWEIGHT AND OBESITY

Management of overweight and obesity in non-clinical settings

Background

This review was one of several commissioned by NICE to inform guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children.

Findings

Overall, for adults, only limited evidence was available. Although twenty two primary studies were identified, the range of interventions evaluated was fairly restricted. There was moderate evidence from one trial that Weightwatchers was more effective than a self-help programme. Two studies of Slimfast were also identified, but there was no strong evidence of effectiveness. There was some evidence that interventions in a work setting can be effective but the evidence was weak and the actual weight loss was small. There was some evidence that the internet was an effective mode of delivery for weight loss interventions. However this evidence was weak, and contradictory evidence, also weak, was found.

Very little evidence was available on interventions for overweight and obese children. There was evidence that an intervention delivered by a physical education teacher was more effective in achieving weight loss than no intervention, though children were only followed for the duration of the three month programme. An intervention delivered by a school nurse was less effective than a more intensive intervention delivered in a clinical setting. There was evidence of effectiveness for a very low calorie diet delivered by mainly clinical staff. In the single home based study a tailored educational website was more effective in conjunction with behaviour modification material and email support from a case manager than without. However there was no strong evidence for the effectiveness of any of these interventions.

Conducted by: CRD

Related guidance

Commissioned to inform NICE clinical guideline 43: Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children. London: National Institute for Health and Clinical Excellence; 2006

Funding

Commissioned by the Centre for Public Health Excellence