Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Open accessAbstract
Importance: Overweight and obesity have been associated with adverse health effects. Objective: To systematically review evidence on benefits and harms of behavioral and pharmacotherapy weight loss and weight loss maintenance interventions in adults to inform the US Preventive Services Task Force. Data Sources: MEDLINE, PubMed Publisher-Supplied Records, PsycINFO, and the Cochrane Central Register of Controlled Trials for studies published through June 6, 2017; ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials through August 2017; and ongoing surveillance in targeted publications through March 23, 2018. Studies from previous reviews were reevaluated for inclusion. Study Selection: Randomized clinical trials (RCTs) focusing on weight loss or weight loss maintenance in adults. Data Extraction and Synthesis: Data were abstracted by one reviewer and confirmed by another. Random-effects meta-analyses were conducted for weight loss outcomes in behavior-based interventions. Main Outcomes and Measures: Health outcomes, weight loss or weight loss maintenance, reduction in obesity-related conditions, and adverse events. Results: A total of 122 RCTs (N = 62 533) and 2 observational studies (N = 209 993) were identified. Compared with controls, participants in behavior-based interventions had greater mean weight loss at 12 to 18 months (-2.39 kg [95% CI, -2.86 to -1.93]; 67 studies [n = 22065]) and less weight regain (-1.59 kg [95% CI, -2.38 to -0.79]; 8 studies [n = 1408]). Studies of medication-based weight loss and maintenance interventions also reported greater weight loss or less weight regain in intervention compared with placebo groups at 12 to 18 months (range, -0.6 to -5.8 kg; no meta-analysis). Participants with prediabetes in weight loss interventions had a lower risk of developing diabetes compared with controls (relative risk, 0.67 [95% CI, 0.51 to 0.89]). There was no evidence of other benefits, but most health outcomes such as mortality, cardiovascular disease, and cancer were infrequently reported. Small improvements in quality of life in some medication trials were noted but were of unclear clinical significance. There was no evidence of harm such as cardiovascular disease from behavior-based interventions; higher rates of adverse events were associated with higher dropout rates in medication groups than in placebo groups. Conclusions and Relevance: Behavior-based weight loss interventions with or without weight loss medications were associated with more weight loss and a lower risk of developing diabetes than control conditions. Weight loss medications, but not behavior-based interventions, were associated with higher rates of harms. Long-term weight and health outcomes data, as well as data on important subgroups, were limited.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Multicomponent behavioral interventions, ideally consisting of at least 14 sessions in 6 months to promote lifestyle changes, often produce 5% to 10% weight loss.
“Moderate- to high-intensity interventions often produce 5% to 10% weight loss (mean, −2.39 kg; 95% CI, −2.86 kg to −1.93 kg),64”
From Obesity Management in Adults (2023) · cites this paper as [64]
The Results report a pooled 2.4 kg greater weight loss than controls (95% CI, 1.9 to 2.8 kg), consistent with the citing sentence’s more precise figures. They also report that intervention participants were more likely to achieve 5% weight loss. The paper does not establish that moderate- to high-intensity interventions often produce 5% to 10% weight loss, or that at least 14 sessions in 6 months is the ideal format. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMaximal weight loss with behavioral interventions is achieved between 6 and 12 months.
“with maximal loss achieved between 6 and 12 months.5,13,64,66”
From Obesity Management in Adults (2023) · cites this paper as [64]
The Results (page unavailable) report greater weight loss with behavior-based interventions at 12–18 months, and the summary-of-findings table (page unavailable) says effects at later follow-up were generally attenuated. Neither passage establishes that maximal weight loss occurs specifically between 6 and 12 months. (LLM, conf=0.83)
Experimental — accuracy not yet measuredModerate- to high-intensity behavioral interventions often produce 5% to 10% weight loss (mean, −2.39 kg; 95% CI, −2.86 kg to −1.93 kg).
“Moderate- to high-intensity interventions often produce 5% to 10% weight loss (mean, −2.39 kg; 95% CI, −2.86 kg to −1.93 kg),64”
From Obesity Management in Adults (2023) · cites this paper as [64]
The Results report a pooled 2.4 kg greater weight loss versus controls at 12–18 months (95% CI, 2.8 to 1.9 kg), consistent with the claim’s more precise figures after rounding. They also report that participants were more likely to achieve 5% weight loss, but do not establish that moderate- to high-intensity interventions often produce 5%–10% loss. The reported kilogram figure is a between-group difference, not the intervention participants’ mean weight loss. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMost reviews on adult antiobesity medications from high profile groups are out of date and do not reflect the available evidence on the most recent antiobesity medication options.
“Most reviews on adult antiobesity medications from high profile groups are also out of date, and do not reflect the available evidence on the most recent antiobesity medication options.179 -182”
From Effectiveness and safety of drugs for obesity (2024) · cites this paper as [182]
The Data Sources and Searches section (page unavailable) dates this review’s final surveillance to March 23, 2018, and Study Selection lists the medications it covered. That establishes it as an example of a review with a defined evidence cutoff, but the paper does not establish that most high-profile reviews are out of date or assess whether they omit evidence on the most recent medication options. (LLM, conf=0.77)
Experimental — accuracy not yet measuredSome randomized controlled trials had relatively poor follow-up rates or short durations.
“Fourth, some RCTs had relatively poor follow-up rates or short durations.13,64”
From Obesity Management in Adults (2023) · cites this paper as [64]
Randomized clinical trials suggest tirzepatide has greater weight-loss efficacy than GLP1-receptor agonists, with mean weight loss of about 20% (placebo-subtracted about 18%) in adults without type 2 diabetes, and 36% losing at least 25% of initial weight.
“RCTs [75][76][77] suggest weight-loss efficacy greater than GLP1-RAs, with mean weight loss of ≈20% (placebo-subtracted ≈18%) in adults without T2D, and 36% losing ≥25% of initial weight.”
From Approach to Obesity Treatment in Primary Care: A Review (2024) · cites this paper as [75]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 221 · Cited by 463
Research works printed but not linked: 1
- [8]8. years. N Engl J Med. 2017;377(1):13-27. doi:10.1056 /NEJMoa1614362
- Authors
- LeBlanc, E. S., Patnode, C. D., Webber, E. M., Redmond, N., Rushkin, M., & O’Connor, E. A.
- Affiliations
- Kaiser Permanente (US)
- Corresponding author
- LeBlanc, Erin S.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2018-09-18
- Volume
- 320
- Issue
- 11
- Pages
- 1172
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC13151892
- OpenAlex
- W2890827307
- Cited by
- 463
- References
- 221
- Citations by year
- 2026: 40 · 2025: 58 · 2024: 60 · 2023: 62 · 2022: 74 · 2021: 67 · 2020: 60 · 2019: 37 · 2018: 4 · 2017: 1
- FWCI
- 4.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health
- Centers for Disease Control and Prevention
- Agency for Healthcare Research and Quality (HHSA290201200015I)
- National Cancer Institute
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- obesity prevention, weight loss interventions, weight loss maintenance, obesity-related morbidity, obesity-related mortality, prediabetes, type 2 diabetes prevention, weight regain, anti-obesity drugs, behavioral weight loss, quality of life, cardiovascular disease, cancer, mortality, adults, overweight, USPSTF recommendations
- MeSH terms
- Obesity Management, Adult, Behavior Therapy, Combined Modality Therapy, Diabetes Mellitus, Type 2, Female, Humans, Male, Obesity, Preventive Health Services, United States, Weight Loss, Health Behavior, Randomized Controlled Trials as Topic, Anti-Obesity Agents
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
