How effective and safe are screening methods and treatments for obesity?
Systematic review with narrative synthesis.
The review found no RCTs that studied the efficacy of obesity screening. Recent RCTs found that high intensity counselling or behavioural interventions and pharmacological interventions could result in moderate weight loss (see Table 1). The RCTs found that side effects were common (11 to 79%) with pharmacological treatment but not usually serious. Three RCTs found no significant differences in weight loss among different methods of gastric banding surgery (open vs. laparoscopic) or different placements of the gastric band (oesophogastric vs. retrogastric; gastric vs. oesophogastric). All gastric banding groups experienced considerable weight loss (from 17kg to over 40kg at 1–2 years follow-up). The RCTs did not report on mortality, but one large cohort study of different surgical techniques reported post-operative mortality of 0.2%.
Counselling or behavioural interventions and pharmacotherapy can result in moderate weight loss (approximately 3 to 5kg) over at least 6–12 months. Pharmacotherapy does have adverse effects. Surgery results in considerable weight loss in very obese people, but there is a risk of mortality.Le texte complet de cet article est disponible en PDF.
Keywords : Obesity, Weight loss, Drug therapy, Surgery, Counselling, Systematic review
| Abstracted from: McTigue KM, Harris R, Hemphill B et al. Screening and interventions for obesity in adults: Summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 2003; 139: 933–949