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Differences in Weight Loss Across Different BMI Classes:A Meta-analysis of the Effects of Interventions with Diet and Exercise

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Abstract

Background

Lifestyle interventions are effective for weight loss and are recommended for persons with a body mass index (BMI) of 25–40 kg m−2. However, this group is very heterogeneous, which could influence outcomes from lifestyle interventions.

Purpose

In this systematic review, differences in 1-year weight change and percentage weight change after lifestyle interventions were investigated for participants varying in initial BMI using meta-analyses.

Method

Twenty-two interventions with healthy Caucasian adults, a mean BMI between 25 and 40 kg m−2, a dietary as well as a physical activity component aiming at weight loss, and at least five contact sessions guided by a professional health care provider were selected from a systematic search in the MEDLINE database. Participants in each intervention were divided into one of the three BMI classes: overweight (BMI of 25–29.99 kg m−2), class-I obesity (BMI of 30–34.99 kg m−2), and class-II obesity (BMI of 35–39.99 kg m−2). Differences in weight change and percentage weight change were analyzed and compared among different BMI classes within the same intervention by calculating standardized mean differences.

Results

Overweight participants lost 1.1 kg less (p < 0.01) than participants with class-I obesity and 1.5 kg less (p < 0.01) than participants with class-II obesity. For percentage weight change, no significant differences were found among the BMI classes.

Conclusion

Average weight change during lifestyle interventions only differs to a small extent among people with BMI between 25 and 40 kg m−2. This implies that these interventions are equally appropriate for these BMI classes.

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Author information

Authors and Affiliations

  1. Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands

    Jeroen C. M. Barte, Jorien Veldwijk & Wanda J. E. Bemelmans

  2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands

    Jorien Veldwijk

  3. Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, Technical University of Lisbon, Lisbon, Portugal

    Pedro J. Teixeira

  4. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    Frank M. Sacks

  5. Channing Laboratory, Department of Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Frank M. Sacks

  6. Behavioural Science Institute, Radboud University, Nijmegen, Nijmegen, the Netherlands

    Jeroen C. M. Barte

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  1. Jeroen C. M. Barte
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  2. Jorien Veldwijk
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  5. Wanda J. E. Bemelmans
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Correspondence to Jeroen C. M. Barte.

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Barte, J.C.M., Veldwijk, J., Teixeira, P.J. et al. Differences in Weight Loss Across Different BMI Classes:A Meta-analysis of the Effects of Interventions with Diet and Exercise. Int.J. Behav. Med. 21, 784–793 (2014). https://doi.org/10.1007/s12529-013-9355-5

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  • DOI: https://doi.org/10.1007/s12529-013-9355-5

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