Self-management interventions for adults living with obesity to improve patient-relevant outcomes: An evidence map.
Rosa Sunol, Ana Isabel González-González, Claudia Valli and 31 others
PMID 36739705WHAT IT FOUND
Across 497 obesity self-management trials, most measured weight, physical activity and nutrition; few measured patient-important outcomes such as quality of life, stigma, coping or shared decision-making.
Key findings
01This evidence map included 497 randomized trials and 99,741 adults living with overweight or obesity.
02Most trials focused on clinical outcomes (55%) or adherence behaviours (23%), while quality of life was reported in less than 14% and cost in less than 1%.
03Interventions were dominated by sharing information, goal setting and self-monitoring; emotional management, social support and shared decision-making were much less frequent.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This is an evidence map, not a test of whether self-management interventions work. It only searched literature published until December 5th, 2018, so newer trials may have changed some gaps. It included only English or Spanish RCTs, excluded surgery and quasi-randomized studies, and allowed mixed populations if at least 80% had overweight or obesity. Many included trials did not clearly report allocation concealment, only 48 studies used blinding or a sham procedure, and around 48% had attrition concerns. Intervention reporting was incomplete, and overweight and obesity were often studied together, so the map cannot say what worked for either group separately. Participants were mostly middle-aged females with a median BMI of 34, and data on socio-economic status, minority groups and health literacy were seldom reported.
Declared interests
Supported by the European Union’s Horizon 2020 research and innovation program; the authors declare no competing interests.
The easy way to misread this
Do not read this as evidence that self-management interventions improve weight, quality of life or daily life. It only maps what has been studied, and many included trials had unclear allocation concealment, low blinding and attrition concerns.