title: Weight reduction for non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is becoming a wide spread liver disease. The present recommendations for treatment are not evidence-based. Some of them are various weight reduction measures with diet, exercise, drug, or surgical therapy.
  
  
  OBJECTIVE
  To assess the benefits and harms of intended weight reduction for patients with NAFLD.
  
  
  METHODS
  We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, PubMed, EMBASE, Science Citation Index Expanded, Chinese Biomedicine Database, and ClinicalTrials.gov until February 2011.
  
  
  METHODS
  We included randomised clinical trials evaluating weight reduction with different measures versus no intervention or placebo in NAFLD patients.
  
  
  METHODS
  We extracted data independently. We calculated the odds ratio (OR) for dichotomous data and calculated the mean difference (MD) for continuous data, both with 95% confidence intervals (CI).
  
  
  RESULTS
  The review includes seven trials; five on aspects of lifestyle changes (eg, diet, physical exercise) and two on treatment with a weight reduction drug 'orlistat'. In total, 373 participants were enrolled, and the duration of the trials ranged from 1 month to 1 year. Only one trial on lifestyle programme was judged to be of low risk of bias. We could not perform meta-analyses for the main outcomes as they were either not reported or there were insufficient number of trials for each outcome to be meta-analysed. We could meta-analyse the available data for body weight and body mass index only. Adverse events were poorly reported.
  
  
  CONCLUSIONS
  The sparse data and high risk of bias preclude us from drawing any definite conclusion on lifestyle programme or orlistat for treatment of NAFLD. Further randomised clinical trials with low risk of bias are needed to test the beneficial and harmful effects of weight reduction for NAFLD patients. The long-term prognosis of development of fibrosis, mortality, and quality of life should be studied.
authors.affiliation: Department of Gastroenterology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China, 200032.
authors.forename: Lijun
authors.initials: L
authors.lastname: Peng
authors.forename: Jiyao
authors.initials: J
authors.lastname: Wang
authors.forename: Feng
authors.initials: F
authors.lastname: Li
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use; D015992:Body Mass Index; D004038:Diet, Reducing; D015444:Exercise; D005234:Fatty Liver / Q000628:therapy; D006801:Humans; D007783:Lactones / Q000627:therapeutic use; D008019:Life Style; D065626:Non-alcoholic Fatty Liver Disease; D000077403:Orlistat; D016032:Randomized Controlled Trials as Topic; D015431:Weight Loss / Q000502:physiology*
chemical_list: D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat