Weight regain after behavioural weight management programmes and its impact on quality of life and cost effectiveness: Evidence synthesis and health economic analyses
Open accessAbstract
Aims: We used data from a recent systematic review to investigate weight regain after behavioural weight management programmes (BWMPs, sometimes referred to as lifestyle modification programmes) and its impact on quality‐of‐life and cost‐effectiveness. Materials and Methods: Trial registries, databases and forward‐citation searching (latest search December 2019) were used to identify randomized trials of BWMPs in adults with overweight/obesity reporting outcomes at ≥12 months, and after programme end. Two independent reviewers screened records. One reviewer extracted data and a second checked them. The differences between intervention and control groups were synthesized using mixed‐effect, meta‐regression and time‐to‐event models. We examined associations between weight difference and difference in quality‐of‐life. Cost‐effectiveness was estimated from a health sector perspective. Results: In total, 155 trials (n > 150 000) contributed to analyses. The longest follow‐up was 23 years post‐programme. At programme end, intervention groups achieved –2.8 kg (95%CI –3.2 to –2.4) greater weight loss than controls. Weight regain after programme end was 0.12‐0.32 kg/year greater in intervention relative to control groups, with a between‐group difference evident for at least 5 years. Quality‐of‐life increased in intervention groups relative to control at programme end and thereafter returned to control as the difference in weight between groups diminished. BWMPs with this initial weight loss and subsequent regain would be cost‐effective if delivered for under £560 (£8.80‐£3900) per person. Conclusions: Modest rates of weight regain, with persistent benefits for several years, should encourage health care practitioners and policymakers to offer obesity treatments that cost less than our suggested thresholds as a cost‐effective intervention to improve long‐term weight management. Registration: The review is registered on PROSPERO, CRD42018105744.
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The BWMP review found benefits for cardiometabolic health lasting for about five years after the end of the programme.
“Furthermore, the BWMP review found benefits for cardiometabolic health lasting for about five years after the end of the programme.”
From Weight regain after cessation of medication for weight management: systematic review and meta-analysis (2026) · cites this paper as [12]
The Results (Weight) and Discussion report a weight difference favouring BWMPs for at least five years after programme end. The review does not establish that cardiometabolic health outcomes themselves remained improved for that period; its five-year finding concerns weight, while health benefits are discussed through modelling. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe rate of weight regain after BWMP was recalculated based solely on data up to two years after treatment cessation, leading to slightly higher estimates than in the original paper.
“We recalculated the rate of weight regain based solely on data up to two years after treatment cessation to mirror the duration of follow-up after WMM, leading to slightly higher estimates for the rate of weight regain than in the original paper.12”
From Weight regain after cessation of medication for weight management: systematic review and meta-analysis (2026) · cites this paper as [12]
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- Authors
- Hartmann‐Boyce, J., Cobiac, L. J., Theodoulou, A., Oke, J. L., Butler, A. R., Scarborough, P., Bastounis, A., Dunnigan, A., Byadya, R., Hobbs, F. D. R., Sniehotta, F. F., Amies‐Cull, B., Aveyard, P., & Jebb, S. A.
- Affiliations
- University of Oxford (GB)
- Griffith University (AU)
- NIHR Oxford Biomedical Research Centre (GB)
- University of Nottingham (GB)
- Royal Free London NHS Foundation Trust (GB)
- World Food Programme (IT)
- Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK
- Newcastle University (GB)
- Corresponding author
- Hartmann‐Boyce, Jamie
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2022-11-02
- Volume
- 25
- Issue
- 2
- Pages
- 526-535
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- PMC
- PMC10092406
- OpenAlex
- W4306166132
- Cited by
- 34
- References
- 22
- Citations by year
- 2026: 13 · 2025: 9 · 2024: 6 · 2023: 5 · 2022: 1
- FWCI
- 4.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Obesity and Metabolism (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion, public-domain)
- Griffith Research Online (submittedVersion, cc-by)
- Greater South Information System
- Funders
- British Heart Foundation
- National Institute for Health Research
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- weight regain, lifestyle modification, obesity, overweight, quality of life, cost-effectiveness, weight loss, long-term weight management, health economics
- MeSH terms
- Adult, Cost-Benefit Analysis, Humans, Obesity, Quality of Life, Weight Gain, Weight Loss, Exercise, Weight Reduction Programs
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