title: Strategies for weight maintenance in adult populations treated for overweight and obesity: a systematic review and meta-analysis.
abstract: BACKGROUND
  Once weight loss is achieved, the challenge is to maintain this benefit. This review reports on the effectiveness of programs for weight-loss maintenance, as part of a larger review examining treatments for overweight and obese adults.
  
  
  METHODS
  We updated the search of a 2011 review on screening and management of overweight and obese adults. Four databases were searched. For inclusion, participants had to have lost weight in treatment and then been randomly assigned to a weight-maintenance intervention or control conditions. Studies from the 2011 review that met the criteria were included. Data were extracted and pooled (where possible) for outcomes related to weight-loss maintenance.
  
  
  RESULTS
  Eight studies were included. Compared with control participants, intervention participants regained less weight (mean difference [MD] -1.44 kg, 95% confidence interval [CI] -2.42 to -0.47), regardless of whether the intervention was behavioural (MD-1.56 kg, 95% CI -3.10 to -0.02) or pharmacologic plus behavioural (MD -1.39 kg, 95% CI -2.86 to 0.08). Intervention participants also showed better weight maintenance than the control participants in terms of waist circumference (MD -2.30 cm, 95% CI -3.45 to -1.15) and body mass index (MD -0.95 kg/m(2), 95% CI -1.67 to -0.23). Participants undergoing pharmacologic plus behavioural interventions were more likely to maintain a loss of 5% or more of initial body weight than those in the control group (risk ratio [RR] 1.33, 95% CI 1.15 to 1.54); no difference was found for maintaining a weight loss of 10% or more (RR 1.76, 95% CI 0.75 to 4.12).
  
  
  CONCLUSIONS
  Moderate quality evidence shows that overweight and obese adults can benefit from interventions for weight maintenance following weight loss. However, there is insufficient evidence on the long-term sustainability of these benefits.
  
  
  BACKGROUND
  PROSPERO no. CRD42012002753.
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, McMaster University, Hamilton, Ont.
authors.forename: Leslea
authors.initials: L
authors.lastname: Peirson
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, McMaster University, Hamilton, Ont.
authors.forename: Donna
authors.initials: D
authors.lastname: Fitzpatrick-Lewis
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, McMaster University, Hamilton, Ont.
authors.forename: Donna
authors.initials: D
authors.lastname: Ciliska
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Usman Ali
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont.
authors.forename: Parminder
authors.initials: P
authors.lastname: Raina
authors.affiliation: McMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ont. ; School of Nursing, McMaster University, Hamilton, Ont.
authors.forename: Diana
authors.initials: D
authors.lastname: Sherifali
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