title: Avoiding weight gain in cardiometabolic disease: a systematic review.
abstract: Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects. Even without weight loss, weight maintenance may be beneficial. We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify comparative studies of lifestyle interventions (self-management, diet, exercise, or their combination) without a weight loss focus in adults with or at risk for diabetes and cardiovascular disease. Weight, BMI, and waist circumference at ≥12 months were the primary outcomes. Of 24,870 citations, we included 12 trials (self-management, n = 2; diet, n = 2; exercise, n = 2; combination, n = 6) studying 4,206 participants. Self-management plus physical activity ± diet versus minimal/no intervention avoided meaningful weight (-0.65 to -1.3 kg) and BMI (-0.4 to -0.7 kg/m(2)) increases. Self-management and/or physical activity prevented meaningful waist circumference increases versus control (-2 to -4 cm). In patients with cardiometabolic disease, self-management plus exercise may prevent weight and BMI increases and self-management and/or exercise may prevent waist circumference increases versus minimal/no intervention. Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes.
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA ; Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Nisa M
authors.initials: NM
authors.lastname: Maruthur
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA.
authors.forename: Kimberly
authors.identifier: 0000-0002-7782-1769
authors.initials: K
authors.lastname: Gudzune
authors.affiliation: Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Susan
authors.identifier: 0000-0002-6311-2611
authors.initials: S
authors.lastname: Hutfless
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Oluwakemi A
authors.initials: OA
authors.lastname: Fawole
authors.affiliation: Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
authors.forename: Renee F
authors.initials: RF
authors.lastname: Wilson
authors.affiliation: Division of Acute Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD 21287, USA.
authors.forename: Brandyn D
authors.initials: BD
authors.lastname: Lau
authors.affiliation: Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA ; Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA 92093, USA.
authors.forename: Cheryl A M
authors.initials: CA
authors.lastname: Anderson
authors.affiliation: Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
authors.forename: Sara N
authors.initials: SN
authors.lastname: Bleich
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
authors.forename: Jodi
authors.initials: J
authors.lastname: Segal
mesh_terms: D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000628:therapy; D003920:Diabetes Mellitus / Q000628:therapy; D004032:Diet; D015444:Exercise; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D009765:Obesity / Q000517:prevention & control*; D055105:Waist Circumference; D015430:Weight Gain