title: Self-help for weight loss in overweight and obese adults: systematic review and meta-analysis.
abstract: We conducted a systematic review and meta-analysis investigating the components and effectiveness of self-help weight-loss interventions and their applicability to less-advantaged populations. We searched (November 2013) for randomized controlled trials comparing self-help interventions with each other or with minimal controls in overweight and obese adults, with 6 months or longer follow-up. We calculated mean difference between intervention and control for 6- and 12-month weight change. Twenty-three studies met the inclusion criteria (9632 participants; 39 intervention arms). Intervention participants lost significantly more weight than controls at 6 months (mean difference -1.85 kg; 95% confidence interval [CI]=-2.86, -0.83; 7 studies). No significant effect was detected at 12 months but results were sensitive to the inclusion of 1 study at high risk of bias. Interactive programs appeared more effective than standard ones at 6 months (mean difference -0.94 kg; 95% CI=-1.50, -0.38). Evidence is insufficient to reach conclusions on effectiveness in socioeconomically disadvantaged people, but suggests self-help interventions may be less effective in this group.
authors.affiliation: All of the authors are with the Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
authors.forename: Jamie
authors.initials: J
authors.lastname: Hartmann-Boyce
authors.forename: Susan A
authors.initials: SA
authors.lastname: Jebb
authors.forename: Ben R
authors.initials: BR
authors.lastname: Fletcher
authors.forename: Paul
authors.initials: P
authors.lastname: Aveyard
mesh_terms: D000328:Adult; D054626:Consumer Health Information / Q000379:methods*; D016206:Databases, Bibliographic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000517:prevention & control / Q000628:therapy*; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods; D012657:Self-Help Groups / Q000191:economics / Q000458:organization & administration*; D012959:Socioeconomic Factors; D015431:Weight Loss / Q000502:physiology; D061217:Weight Reduction Programs / Q000191:economics / Q000379:methods / Q000458:organization & administration*