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Weight-loss intervention adherence and factors promoting adherence: a meta-analysis

Authors Lemstra M, Bird Y, Nwankwo C, Rogers M, Moraros J

Received 5 January 2016

Accepted for publication 3 March 2016

Published 12 August 2016 Volume 2016:10 Pages 1547—1559

DOI https://doi.org/10.2147/PPA.S103649

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Mark Lemstra,1 Yelena Bird,2 Chijioke Nwankwo,2 Marla Rogers,3 John Moraros2

1Alliance Wellness and Rehabilitation, Moose Jaw, 2School of Public Health, 3College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada


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.

Keywords: community based, obesity, social support, program adherence

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