A systematic review of commercial weight loss programmes' effect on glycemic outcomes among overweight and obese adults with and without type 2 diabetes mellitus - PubMed (original) (raw)

A systematic review of commercial weight loss programmes' effect on glycemic outcomes among overweight and obese adults with and without type 2 diabetes mellitus

Z W Chaudhry et al. Obes Rev. 2016 Aug.

Abstract

Objective: We examined the glycemic benefits of commercial weight loss programmes as compared with control/education or counselling among overweight and obese adults with and without type 2 diabetes mellitus (T2DM).

Methods: We searched MEDLINE, Cochrane Database of Systematic Reviews, and references cited by individual programmes. We included randomized controlled trials of ≥12 weeks duration. Two reviewers extracted information on study design, population characteristics, interventions, and mean changes in haemoglobin A1c and glucose.

Results: We included 18 randomized controlled trials. Few trials occurred among individuals with T2DM. In this population, Jenny Craig reduced A1c at least 0.4% more than counselling at 12 months, Nutrisystem significantly reduced A1c 0.3% more than counselling at 6 months, and OPTIFAST reduced A1c 0.3% more than counselling at 6 months. Among individuals without T2DM, few studies evaluated glycemic outcomes, and when reported, most did not show substantial reductions.

Discussion: Few trials have examined whether commercial weight loss programmes result in glycemic benefits for their participants, particularly among overweight and obese individuals without T2DM. Jenny Craig, Nutrisystem and OPTIFAST show promising glycemic lowering benefits for patients with T2DM, although additional studies are needed to confirm these conclusions. © 2016 World Obesity.

Keywords: Commercial weight loss; glucose; haemoglobin A1c; type 2 diabetes mellitus.

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Conflict of interest statement

Disclosures: The authors have no relevant conflicts of interest to disclose.

Figures

Figure 1

Summary of evidence search and selection. *Other exclusions included trials with ineligible study designs (retrospective case series, RCT<12 weeks duration, etc) or ineligible programs (not available in the US, etc). **Ineligible commercial programs include those that use medications or supplements, modified specifically for the study, unavailable in the U.S., or available only to special populations like active duty military or veterans. Abbreviations: CDSR – Cochrane Database of Systematic Reviews; RCT – randomized controlled trial.

Figure 2

Difference in mean hemoglobin A1c change (%) between commercial programs and comparators among populations with type 2 diabetes mellitus, displayed by time point. Diamond size is standardized across trials and does not reflect sample size analyzed. *Results reported in more than one article. **Results from completers’ analysis only. ***Trials where reported attrition was not reported or was high (attrition ≥30% in one arm or difference in attrition between arms was ≥20%). Abbreviations: C – Comparator; LC – Low Carbohydrate Version; NR – Not Reported; P – Commercial Program.

Figure 3

Difference in mean glucose change (mmol/L) between commercial programs and comparators among populations with type 2 diabetes mellitus, displayed by time point. Diamond size is standardized across trials and does not reflect sample size analyzed. To convert mmol/L to mg/dL, divide values by 0.05551. *Results reported in more than one article. **Results from completers’ analysis only. ***Trials where reported attrition was not reported or was high (attrition ≥30% in one arm or difference in attrition between arms was ≥20%). Abbreviations: C – Comparator; NR – Not Reported; P – Commercial Program.

Figure 4

Difference in mean glucose change (mmol/L) between commercial programs and comparators among populations at increased risk of type 2 diabetes mellitus displayed by time point displayed. Diamond size is standardized across trials and does not reflect sample size analyzed. To convert mmol/L to mg/dL, divide values by 0.05551. *Results reported in more than one article. **Results from completers’ analysis only. ***Trials where reported attrition was not reported or was high (attrition ≥30% in one arm or difference in attrition between arms was ≥20%). Abbreviations: C – Comparator; HMR – Health Management Resources; NR – Not Reported; P – Commercial Program; WW – Weight Watchers.

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A systematic review of commercial weight loss programmes' effect on glycemic outcomes among overweight and obese adults with and without type 2 diabetes mellitus - PubMed (original) (raw)