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In obese men, diet and exercise programs can lead to weight loss

Robertson C, Archibald D, Avenell A, et al. Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men. Health Technol Assess. 2014;18:v-vi, xxiii-xxix, 1-424.

Review question

In obese men, which treatments increase weight loss or help to maintain weight?

Background

Obesity can have negative effects on health and increases the risk of diseases like heart disease, diabetes and osteoarthritis. Modest weight loss can improve or prevent these negative health effects. People who have a body mass index (BMI) of at least 30 kg/m2 are considered obese. The BMI is calculated as weight (in kilograms) divided by height (in metres squared). Men who are obese are less likely to consider the health effects of obesity and to manage their weight.

How the review was done

The researchers did a systematic review, searching for articles published up to July 2012. They found 11 randomized controlled trials with 1238 men (median age range 36 to 62 years).

The trials included obese men (BMI at least 30 kg/m2) or overweight men (BMI at least 28 kg/m2) who also had risk factors for cardiac disease.

The effects of any type of treatment that promoted weight loss or weight maintenance, including diet, exercise, or behavioural therapy, were assessed.

What the researchers found

An exercise program or calorie-reduced diet (by 300 to 500 kcal/day) resulted in greater weight loss than no exercise or diet.

A calorie-reduced diet resulted in greater weight loss than an exercise program.

A low-fat diet plus behavioural therapy and exercise advice did not differ from no treatment at 1 year; at 2 years, the treatment group lost 29 lb (13 kg) more.

Diet plus exercise did not differ from diet alone at 1 and 1.5 years; at 3 years, diet plus exercise resulted in 18 lb (8.2 kg) greater weight loss (as low as 2 lb [1 kg] to as much as 33 lb [15 kg]).

A high-protein diet did not differ from a high carbohydrate diet.

Behavioural therapy for weight maintenance did not differ from no treatment.

Conclusion

In obese men, diet and exercise programs can lead to weight loss.

Exercise, diet, and behavioural programs to reduce or maintain weight in obese men

Outcomes

Comparisons

Effects on weight loss or maintenance

Weight loss

Exercise program vs no diet or exercise

1 trial (89 men): men in the exercise program lost an average of 10 lb (4.6 kg) more at 1 year

 

Calorie-reduced diet vs no diet or exercise

1 trial (84 men): men in the diet group lost 17 lb (7.8 kg) more at 1 year

 

Calorie-reduced diet vs exercise program

1 trial (89 men): men in the diet group lost 7 lb (3.2 kg) more at 1 year

 

Low-fat reducing diet + behavioural therapy + exercise advice vs no treatment

2 trials (506 men): groups did not differ at 1 year

1 trial (110 men): men in the diet + behavioural therapy + exercise advice group lost 29 lb (13 kg) more at 2 years

 

Diet + exercise vs diet alone

1 trial (19 men): groups did not differ at 1 year

1 trial (131 men): groups did not differ at 1.5 years

1 trial (21 men): men in the diet + exercise group lost 18 lb (8.2 kg) more (as little as 2 lb [1 kg] to as much as 33 lb [15 kg]) at 3 years

 

High-protein vs high-carbohydrate diet

1 trial (33 men): groups did not differ at 1 year

Weight maintenance

Behavioural therapy vs no treatment

1 trial (72 men): groups did not differ at 1 year

 




Glossary

Median
The number separating the higher half from the lower half. 50% are above that point and 50% are below.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Risk factors
Aspects making a condition more likely.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

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