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Weight reduction for primary prevention of stroke in adults with overweight or obesity

Rigorous scientific evidence linking overweight or obesity with increased risk for stroke is missing.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Exercise for overweight or obesity

Overweight and obesity are important public health problems and are associated with many serious health conditions. The risk of developing overweight and obesity depends on lifestyle factors such as food intake and physical activity levels. Treatment for overweight and obesity therefore commonly involves diet and exercise. We found that exercise has a positive effect on body weight and cardiovascular disease risk factors in people with overweight or obesity, particularly when combined with diet, and that exercise improves health even if no weight is lost. No data were identified on adverse events, quality of life, morbidity, costs or mortality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Low glycaemic index or low glycaemic load diets for overweight and obesity

There is a lack of consensus as to the best nutritional management of obesity. We assessed the effects of low glycaemic index or glycaemic load diets in overweight or obese people. Six randomised controlled trials, involving 202 participants, were analysed. Interventions ranged from five weeks to six months duration. Participants receiving the low glycaemic index or load diet lost a mean of one kilogramme more than those on comparison diets. Lipid profile also improved more in participants receiving the low glycaemic index or load diet. No study reported adverse effects, mortality or quality of life data.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Chitosan for overweight or obesity

Overweight and obesity are common health conditions worldwide but there are few effective treatments. Chitosan is a widely available dietary supplement that claims to aid weight loss and blood cholesterol levels. Fifteen studies which lasted between 4 to 24 weeks including a total of 1219 participants were analysed. Trials of chitosan to date have varied considerably in terms of quality. The review suggests that chitosan may have a small effect on body weight but results from high quality trials indicate that this effect is likely to be minimal.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese adults

Although obesity used to be confined largely to high income countries, the proportion of people who are overweight or obese is now increasing globally. Obesity is a major risk factor for a number of chronic diseases, which have negative consequences for individuals, populations, and health service costs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Long‐term drug pharmacotherapy for obesity and overweight

This review assessed the long‐term benefits and risks of approved anti‐obesity drugs in clinical trials of 1 to 4 years duration. Sixteen orlistat (10,631 patients), 10 sibutramine (2623 patients) and four rimonabant (6635 patients) studies were examined. High drop‐out rates (30% to 40%) were a limitation of nearly all studies. Compared to placebo, all three drugs reduced weight by around five kg or less and orlistat reduced the number of high‐risk patients who developed diabetes. No data to show that any of the three drugs lowers the risk of death or cardiovascular disease were found. The most prominent side effects were gastrointestinal for orlistat, cardiovascular for sibutramine (raised blood pressure and/or pulse rate) and psychiatric for rimonabant (mood disorders). In Europe, rimonabant is contraindicated for patients with severe depression and/or patients who are treated with antidepressive medications. Rimonabant is furthermore not recommended for patients with other untreated psychiatric conditions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Rimonabant for overweight or obesity

Rimonabant is the first drug of a new class of medications that seems to reduce body weight and improve risk factors for diseases of the blood vessels and heart in people who are overweight or obese. We found four studies which evaluated weight loss, occurrence of disorders and adverse effects of treatment. The four studies involved 6625 people comparing rimonabant 20 mg with rimonabant 5 mg and placebo, in combination with a hypocaloric diet after one or two years of treatment. Greater weight loss and improvement in risk factors were seen after 20 mg of rimonabant. These results have to be interpreted with caution though, due to high discontinuation rates of study participants and the overall low quality of the included studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Hormones for birth control in overweight or obese women

Excess body weight has become a problem around the world. Being overweight or obese may affect how well some birth control methods work to prevent pregnancy.  Hormonal birth control includes birth control pills, the skin patch, the vaginal ring, implants, and injectables. We looked at studies of hormonal birth control for women who were overweight or obese compared to women of normal weight or body mass index (BMI). The formula for BMI is weight (kg) / height (m)2.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Green tea for weight loss and weight maintenance in overweight or obese adults

Green tea has a long history of many uses, one of which is helping overweight people to lose weight and to maintain weight loss. Believed to be able to increase a person's energy output, green tea weight loss preparations are extracts of green tea that contain a higher concentration of ingredients (catechins and caffeine) than the typical green tea beverage prepared from a tea bag and boiling water. This review looked at 15 weight loss studies and three studies measuring weight maintenance where some form of a green tea preparation was given to one group and results compared to a group receiving a control. Neither group knew whether they were receiving the green tea preparation or the control. A total of 1945 participants completed the studies, ranging in length from 12 to 13 weeks. In summary, the loss in weight in adults who had taken a green tea preparation was statistically not significant, was very small and is not likely to be clinically important. Similar results were found in studies that used other ways to measure loss in weight (body mass index, waist circumference). Studies examining the effect of green tea preparations on weight maintenance did not show any benefit compared to the use of a control preparation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Behaviour changes for dietary and physical exercise modification in overweight and obese adults

Generally, weight loss programmes tend to involve diet and physical activity interventions. The TTM describes a series of five SOC an individual goes through when changing from an unhealthy behaviour to a healthy one. In this review, we assessed the use of the TTM SOC in weight management programmes for overweight and obese adults especially in terms of the effects on weight loss, dietary habits, physical activity and behaviour changes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interactive computer‐based interventions for weight loss or weight maintenance in overweight or obese people

Overweight and obesity are common health problems and increase the risk of developing several serious health conditions. The standard treatment for overweight and obesity is to help patients change their diet and exercise habits. Treatment programs in which patients interact with a computer may help people make these changes, and improve their ability to lose weight and keep it off. We looked for randomized or quasi‐randomized trials in which an interactive computer intervention was compared with no treatment, a limited treatment such as usual care or paper materials, or an in‐person treatment to help people lose weight or keep it off. We included 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants. The length of treatment ranged from four weeks to 30 months. At six months, computer‐based interventions led to greater weight loss than minimal interventions (mean difference ‐1.5 kg; 95% confidence interval (CI) ‐2.1 to ‐0.9; two trials) but less than in‐person treatment (mean difference 2.1 kg; 95% CI 0.8 to 3.4; one trial). At six months, computer‐based interventions were superior to a minimal control intervention in limiting weight regain (mean difference ‐0.7 kg; 95% CI ‐1.2 to ‐0.2; two trials), but not superior to infrequent in‐person treatment (mean difference 0.5 kg; 95% ‐0.5 to 1.6; two trials).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Keeping Children at a Healthy Weight: A Review of the Research on Ways To Avoid Becoming Overweight or Obese

This summary will cover: How to know if your child is at a healthy weight What body mass index (BMI) is and what BMI percentiles are What health problems being overweight or obese could cause in a child What might lead to a child becoming overweight or obese What can be done at home, in school, and in the community to help keep children from becoming overweight or obese What researchers have found about things that can be done at home, at school, and in the community

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: September 19, 2013

Chromium picolinate supplementation for overweight or obese people

Chromium is an essential nutrient (trace element) required for the normal metabolism of carbohydrate, protein and fat (i.e. the chemical reactions involved in breaking down these molecules to a form suitable for absorption by the body). Chromium increases the activity of insulin, and dietary supplementation with chromium has produced improvements in glucose metabolism which may lower blood glucose being important for overweight people with diabetes. It is generally believed that chromium may help to reduce a person's weight by decreasing the amount of fat in the body. Chromium is also said to suppress the appetite and stimulate the production of heat by the body, thus increasing energy expenditure. This may contribute to weight loss. Chromium picolinate is one of several chemical compounds of chromium sold as a nutritional supplement as a potential aid to weight loss.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Lifestyle interventions for improving school achievement in overweight or obese children and adolescents

Many children and adolescents worldwide are overweight or obese. Children and adolescents who are overweight or obese have increased physical disease and emotional distress. They also perform less well on tests of thinking (cognitive ability), and they do less well in school. To prevent and treat obesity, several lifestyle changes have been suggested, for example, being more physically active, eating fewer calories and sitting less. These interventions are known to improve thinking skills and school achievement in children of normal weight. It is unknown whether the effects are the same in overweight or obese children and adolescents.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Treating obesity in children

Childhood obesity affects both the physical and psychosocial health of children and may put them at risk of ill health as adults. More information is needed about the best way to treat obesity in children and adolescents. In this review, 64 studies were examined including 54 studies on lifestyle treatments (with a focus on diet, physical activity or behaviour change) and 10 studies on drug treatment to help overweight and obese children and their families with weight control. No surgical treatment studies were suitable to include in this review. This review showed that lifestyle programs can reduce the level of overweight in child and adolescent obesity 6 and 12 months after the beginning of the program. In moderate to severely obese adolescents, a reduction in overweight was found when either the drug orlistat, or the drug sibutramine were given in addition to a lifestyle program, although a range of adverse effects was also noted. Information on the long‐term outcome of obesity treatment in children and adolescents was limited and needs to be examined in some high quality studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

The effect of a healthy lifestyle for women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a very common condition affecting 4% to 18% of women. Being overweight worsens all clinical features of PCOS. These clinical features include reproductive manifestations such as reduced frequency of ovulation and irregular menstrual cycles, reduced fertility, polycystic ovaries on ultrasound, and high male hormones such as testosterone which can cause excess facial or body hair growth and acne. PCOS is also associated with metabolic features and diabetes and cardiovascular disease risk factors including high levels of insulin or insulin resistance and abnormal cholesterol levels. PCOS affects quality of life and can worsen anxiety and depression either due to the features of PCOS or due to the diagnosis of a chronic disease. A healthy lifestyle consists of a healthy diet, regular exercise and achieving and maintaining a healthy weight. This review identified six studies with 164 participants that assessed the effects of a healthy lifestyle in women with PCOS. In this review, there were no studies reporting on fertility outcomes such as pregnancy, live birth and miscarriage. While some studies reported on menstrual regularity and ovulation, the findings were reported in a variety of ways and it was not possible to estimate the overall effects of lifestyle on these outcomes. Current evidence suggests that following a healthy lifestyle reduces body weight and abdominal fat, reduces testosterone and improves both hair growth, and improves insulin resistance. There was no evidence that a healthy lifestyle improved cholesterol or glucose levels in women with PCOS.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Calorie‐controlled diets for chronic asthma

It is thought that high calorie diets may contribute to the development of asthma. Theoretically, reducing the amount of calorie consumed as part of a diet may help to alleviate the symptoms of asthma. This review was limited by the small size of the studies and the obese population of asthma patients recruited to the study. No firm conclusions can be drawn regarding the effects of dietary manipulation, and more research is required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Interventions to reduce weight gain in schizophrenia

Weight gain and obesity is a common problem for people with schizophrenia and both pharmacological (medication) and non pharmacological (diet/exercise) interventions have been tried to treat this problem. In this review we are able to show that small weight loss is possible with selective pharmacological or non‐pharmacological interventions but it is difficult to be sure of the results because the studies were small and compared different interventions over different time periods.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus

Obesity is closely related to type 2 diabetes and weight reduction is an important part of the care delivered to obese persons with diabetes. This review of drugs for weight loss among adults with type 2 diabetes revealed weight loss of between 2.0 and 5.1 kg for fluoxetine, orlistat and sibutramine at follow‐up of up to 57 weeks. The long‐term effects remain uncertain. Adverse events were common in all three drugs: gastrointestinal side effects with orlistat; tremor, somnolence, and sweating with fluoxetine; and palpitations with sibutramine. There were few studies examining other drugs used for weight loss in populations with diabetes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Trials of interventions for pregnant women who are obese to lose weight and improve pregnancy outcomes.

Pregnant women who are obese risk serious complications for themselves and their children. The mother is more likely to develop diabetes or high blood pressure or pre‐eclampsia during pregnancy, and the pregnancy may end in a miscarriage or stillbirth. The baby could have serious anomalies at birth, including spina bifida, cardiovascular anomalies, cleft lip and palate, or limb reduction anomalies. Some obese women have premature births. At birth, the labour may be longer and other complications can lead to a caesarean birth. The baby may also be bigger at birth than is normal, and there is evidence that the children of obese mothers go on to be obese. The advice for obese women in managing their weight during pregnancy is that weight loss should be avoided, and weight gain should be between 5.0 and 9.1 kg. Yet observational studies of large numbers of pregnant women indicate that some obese women, especially those who are heavier, lose weight during pregnancy. We do not have any clear results that indicate that losing weight when pregnant is safe for a mother who is obese, or for her baby. This Cochrane review aimed to evaluate trials that were designed for obese pregnant women to lose weight. No randomised controlled trials were found. We recommend that further research is conducted to evaluate the safety of interventions for weight loss when a woman is pregnant and obese for the mother and her baby.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

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