title: Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005.
abstract: OBJECTIVE
  To identify geriatric obesity interventions that can guide clinical recommendations.
  
  
  METHODS
  Systematic review using Medline (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, EMBASE (Ovid), and PsycINFO (Proquest) from January 1, 2005, to October 12, 2015, to identify English-language randomized controlled trials.
  
  
  METHODS
  Individuals aged 60 and older (mean age ≥65) and classified as having obesity (body mass index ≥30 kg/m2).
  
  
  METHODS
  Behavioral weight loss interventions not involving pharmacological or procedural therapies lasting 6 months or longer.
  
  
  METHODS
  Two investigators performed the systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and achieved a high concordance rate (97.3%) in summarizing the primary outcomes. The three primary outcomes were weight loss, physical performance, and quality of life.
  
  
  RESULTS
  Of 5,741 citations, 19 were included. (Six studies were unique, and the remaining 13 were based on the same study population.) Duration ranged from 6 to 18 months (n = 405 participants, age range 66.7-71.1). Weight loss in the intervention groups ranged from 0.5 to 10.7 kg (0.1-9.3%). Five studies had a resistance exercise program accompanying a dietary component. Greater weight loss was observed in groups with a dietary component than those with exercise alone. Exercise alone led to better physical function but no significant weight loss. Combined dietary and exercise components led to the greatest improvement in physical performance measures and quality of life and mitigated reductions in muscle and bone mass observed in diet-only study arms. Heterogeneous outcomes were observed, which limited the ability to synthesize the data quantitatively.
  
  
  CONCLUSIONS
  The evidence supporting geriatric obesity interventions to improve physical function and quality of life is of low to moderate quality. Well-designed trials are needed in this population.
authors.affiliation: Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.|Weight & Wellness Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.|Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire.|Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire.|The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.|Health Promotion Research Center at Dartmouth, Lebanon, New Hampshire.
authors.forename: John A
authors.identifier: http://orcid.org/0000-0002-0845-4416
authors.initials: JA
authors.lastname: Batsis
authors.affiliation: Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire.|The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.
authors.forename: Lydia E
authors.initials: LE
authors.lastname: Gill
authors.affiliation: Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire.|Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Masutani
authors.affiliation: Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire.|The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.|Health Promotion Research Center at Dartmouth, Lebanon, New Hampshire.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Adachi-Mejia
authors.affiliation: Biomedical Libraries, Dartmouth College, Hanover, New Hampshire.
authors.forename: Heather B
authors.initials: HB
authors.lastname: Blunt
authors.affiliation: Biomedical Libraries, Dartmouth College, Hanover, New Hampshire.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Bagley
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
authors.affiliation: Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire.|Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire.|The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.|Health Promotion Research Center at Dartmouth, Lebanon, New Hampshire.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bartels
mesh_terms: D015992:Body Mass Index; D004038:Diet, Reducing; D015444:Exercise; D006801:Humans; D009765:Obesity / Q000628:therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: interventions; obesity; systematic review; weight loss