Is the prevalence of successful weight loss and maintenance higher in the general community than the research clinic?
OBJECTIVE
The prevalence of successful weight loss remains unclear. In 1982, Schachter concluded that in the general population, the rate of "self-cured" obesity approached 63%-much higher than the rate from clinical trials. Several subsequent studies have addressed this issue.


METHODS
Our initial goal was to meta-analyze these studies to evaluate the validity of the original hypotheses and the extent to which additional investigations supported the findings. We began by restating Schachter's hypotheses in precise, testable terms.


RESULTS
A systematic review of these studies found many methodological limitations and much heterogeneity among the samples studied, hypotheses addressed, and operational definitions. Some of these limitations appear to stem from the lack of clear, precise statements of the exact hypotheses tested. Differences among studies are delineated, and we outline why meta-analytic pooling of these data appears inappropriate.


CONCLUSIONS
The current data are inadequate to draw any definite conclusions regarding the cure rate of obesity. Criteria for the adequate study of success rates with "self-cure" in the general population are proposed.
Bartlett
S J
SJ
Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
Faith
M S
MS
Fontaine
K R
KR
Cheskin
L J
LJ
Allison
D B
DB
D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D009765:Obesity / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D015431:Weight Loss