title: Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project).
abstract: Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials' registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2(or ≥28 kg/m2with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program -3.2 kg, 95% confidence interval -4.8 to -1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was -4.9 kg, 95% confidence interval -5.9 to -4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.
authors.affiliation: 1 University of Aberdeen, Aberdeen, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Robertson
authors.affiliation: 1 University of Aberdeen, Aberdeen, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Avenell
authors.affiliation: 1 University of Aberdeen, Aberdeen, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Stewart
authors.affiliation: 2 University of Edinburgh, Edinburgh, UK.
authors.forename: Daryll
authors.initials: D
authors.lastname: Archibald
authors.affiliation: 1 University of Aberdeen, Aberdeen, UK.
authors.forename: Flora
authors.initials: F
authors.lastname: Douglas
authors.affiliation: 3 University of Stirling, Stirling, UK.
authors.forename: Pat
authors.initials: P
authors.lastname: Hoddinott
authors.affiliation: 4 Bournemouth University, Bournemouth, UK.
authors.forename: Edwin
authors.initials: E
authors.lastname: van Teijlingen
authors.affiliation: 1 University of Aberdeen, Aberdeen, UK.
authors.forename: Dwayne
authors.initials: D
authors.lastname: Boyers
mesh_terms: D015992:Body Mass Index; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D008571:Men; D009765:Obesity / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015431:Weight Loss
keywords: behavioral issues; men’s health interventions; obesity