Weight Management Interventions Provided by a Dietitian for Adults with Overweight or Obesity: An Evidence Analysis Center Systematic Review and Meta-Analysis
Open accessAbstract
Background Obesity is associated with a multitude of comorbidities and considerable health care costs.Objective The objective of this review was to examine the efficacy of weight management interventions provided by a registered dietitian or international equivalent (referred to as "dietitian").Methods This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of weight management interventions provided by a dietitian, compared with usual care or no intervention, on several cardiometabolic outcomes and quality of life in adults with overweight or obesity. MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and CINAHL databases were searched for eligible RCTs published between January 2008 and January 2021 in the English language. Meta-analyses were conducted using a random-effects model, publication bias was assessed using funnel plots and Egger's statistics, and heterogeneity was assessed by interpreting I 2 values. Efficacy of intervention components, such as telehealth or group contacts, were explored in sub-group analyses. Version 2 of the risk-of-bias tool for RCTs was used to assess risk of bias. The Grading of Recommendations Assessment, Development and Evaluation method was used to determine certainty of evidence.Results This systematic review included 62 RCTs. Compared with control conditions, weight management interventions provided by a dietitian resulted in improved body mass index (mean difference [MD] -1.5; 95% CI -1.74 to -1.26; moderate evidence certainty); percent weight loss (MD -4.01%; 95% CI -5.26% to -2.75%; high evidence certainty); waist circumference (MD -3.45 cm; 95% CI -4.39 to -2.51 cm; high evidence certainty); blood pressure (MD -3.04 mm Hg; 95% CI -5.10 to -0.98 mm Hg and MD -1.99 mm Hg; 95% CI -3.02 to -0.96 mm Hg for systolic blood pressure and diastolic blood pressure, respectively; moderate and low evidence certainty); and quality of life using the 36-Item Short Form Survey (MD 5.84; 95% CI 2.27 to 9.41 and 2.39; 95% CI 1.55 to 3.23 for physical and mental quality of life, respectively; low and moderate evidence certainty).Conclusions For adults with overweight or obesity, weight management interventions provided by a dietitian are efficacious for improving several examined cardiometabolic outcomes and quality of life.
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In a systematic review of 62 randomized controlled trials, patients with overweight or obesity who received counselling from a dietitian had a greater reduction in BMI compared with usual care or no intervention (mean difference −1.5 kg/m2; 95% CI: 1.74, −1.26).
“patients with overweight or obesity who received counselling from a dietitian had a greater reduction in BMI (mean difference −1.5 kg/m2; 95 % CI: 1.74, −1.26)”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [103]
In the same systematic review, dietitian counselling was associated with greater reduction in diastolic blood pressure compared with usual care or no intervention (1.99 mmHg; 95% CI: 3.02, −0.96).
“diastolic: 1.99 mmHg; 95 % CI: 3.02, −0.96”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [103]
In the same systematic review, dietitian counselling was associated with improvement in mental and physical quality of life measured using the SF-36 tool compared with usual care or no intervention.
“improvement in mental and physical quality of life measured using the SF-36 tool compared with patients who received usual care or no intervention [103]”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [103]
In the same systematic review, dietitian counselling was associated with greater reduction in systolic blood pressure compared with usual care or no intervention (3.04 mmHg; 95% CI: 5.10, −0.98).
“systolic: 3.04 mmHg; 95 % CI: 5.10, −0.98”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [103]
Greater involvement of dietitians in patient care improves nutrition-related clinical outcomes.
“Greater involvement of dietitians in patient care has been shown to improve nutrition-related clinical outcomes.”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [103]
In the same systematic review, dietitian counselling was associated with greater percent weight reduction compared with usual care or no intervention (−4.01%; 95% CI: 5.26, −2.75).
“percent weight reduction (−4.01 %; 95 % CI: 5.26, −2.75)”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [103]
In the same systematic review, dietitian counselling was associated with greater reduction in waist circumference compared with usual care or no intervention (−3.45 cm; 95% CI: 4.39, −2.51).
“waist circumference (−3.45 cm; 95 % CI: 4.39, −2.51)”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [103]
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Morgan-Bathke, M., Raynor, H. A., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Garay, J. L., & Rozga, M. (2023) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2022.11.014 · Cited by 85 · see citing works
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Expansion of Medicare Coverage for Medical Nutrition Therapy
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- Authors
- Morgan-Bathke, M., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Raynor, H. A., Garay, J. L., & Rozga, M.
- Affiliations
- Viterbo University (US)
- University of South Carolina (US)
- University of Utah (US)
- Oakland University (US)
- California State University, San Bernardino (US)
- University of Tennessee at Knoxville (US)
- Syracuse University (US)
- Academy of Nutrition and Dietetics (US)
- Corresponding author
- Rozga, Mary
- ORCID
- Venue
- Journal of the Academy of Nutrition and Dietetics
- Publisher
- Elsevier BV
- Published
- 2023-11
- Volume
- 123
- Issue
- 11
- Pages
- 1621-1661.e25
- ISSN
- 2212-2672 (ISSN-L)
- OpenAlex
- W4283743174
- Cited by
- 54
- References
- 102
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 18 · 2023: 2 · 2022: 1
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the Academy of Nutrition and Dietetics (acceptedVersion)
- PubMed (publishedVersion)
- Funders
- Academy of Nutrition and Dietetics Foundation
- Academy of Nutrition and Dietetics
- National Institutes of Health (5R01DK121360, KL2TR002539)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- weight management interventions, dietitians, obesity, overweight, cardiometabolic outcomes, blood pressure, waist circumference, body mass index, weight loss, quality of life, telemedicine, group intervention, usual care, adults, quality of evidence, risk of bias, subgroup analysis
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.
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