The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials
Open accessAbstract
Background: Weight-loss maintenance remains a major challenge in obesity treatment. Objective: The objective was to evaluate the effects of anti-obesity drugs, diet, or exercise on weight-loss maintenance after an initial very-low-calorie diet (VLCD)/low-calorie diet (LCD) period (<1000 kcal/d). Design: We conducted a systematic review by using MEDLINE, the Cochrane Controlled Trial Register, and EMBASE from January 1981 to February 2013. We included randomized controlled trials that evaluated weight-loss maintenance strategies after a VLCD/LCD period. Two authors performed independent data extraction by using a predefined data template. All pooled analyses were based on random-effects models. Results: Twenty studies with a total of 27 intervention arms and 3017 participants were included with the following treatment categories: anti-obesity drugs (3 arms; n = 658), meal replacements (4 arms; n = 322), high-protein diets (6 arms; n = 865), dietary supplements (6 arms; n = 261), other diets (3 arms; n = 564), and exercise (5 arms; n = 347). During the VLCD/LCD period, the pooled mean weight change was −12.3 kg (median duration: 8 wk; range 3–16 wk). Compared with controls, anti-obesity drugs improved weight-loss maintenance by 3.5 kg [95% CI: 1.5, 5.5 kg; median duration: 18 mo (12–36 mo)], meal replacements by 3.9 kg [95% CI: 2.8, 5.0 kg; median duration: 12 mo (10–26 mo)], and high-protein diets by 1.5 kg [95% CI: 0.8, 2.1 kg; median duration: 5 mo (3–12 mo)]. Exercise [0.8 kg; 95% CI: −1.2, 2.8 kg; median duration: 10 mo (6–12 mo)] and dietary supplements [0.0 kg; 95% CI: −1.4, 1.4 kg; median duration: 3 mo (3–14 mo)] did not significantly improve weight-loss maintenance compared with control. Conclusion: Anti-obesity drugs, meal replacements, and high-protein diets were associated with improved weight-loss maintenance after a VLCD/LCD period, whereas no significant improvements were seen for dietary supplements and exercise.
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“These studies reported no evidence of a beneficial effect of exercise on weight maintenance.”
From Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies (2021) · cites this paper as [17]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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“No significant effect of exercise was found on weight maintenance (1 SR‐MA).”
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“Contrary to our expectations, our literature search identified only one SR‐MA including three RCTs17 and one additional RCT published in 2018.”
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Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Bias in meta-analysis detected by a simple, graphical test
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Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763
Fuller, N. R., Colagiuri, S., SCHOFIELD, D. J., Olson, A. D., Shrestha, R. N., Holzapfel, C., Wolfenstetter, S. B., Holle, R., Ahern, A. L., Hauner, H., et al. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.139 · Cited by 2,127
Long-term persistence of hormonal adaptations to weight loss
Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1105816 · Cited by 1,449
Long-term weight-loss maintenance: a meta-analysis of US studies
Anderson, J. W., Konz, E. C., Frederich, R. C., & Wood, C. L. (2001) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/74.5.579 · Cited by 1,351
Elfhag, K., & Rössner, S. (2005) · Obesity Reviews · doi:10.1111/j.1467-789x.2005.00170.x · Cited by 1,343 · cited 1×
“There appear to be $3 different drivers behind weight regain after a large weight loss, including adaptive thermogenesis and reduced energy expenditure (37), increased circulation of appetite-mediating hormones (38), and relapse into old habits (39).”
BackgroundA descriptive study of individuals successful at long-term maintenance of substantial weight loss
Klem, M., Wing, R., McGuire, M., Seagle, H., & Hill, J. (1997) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/66.2.239 · Cited by 1,060
Discrepancy between self-reported and actual caloric intake and exercise in obese subjects
Lichtman, S. W., Pisarska, K., Berman, E. R., Pestone, M., Dowling, H., Offenbacher, E., Weisel, H., Heshka, S., Matthews, D. E., & Heymsfield, S. B. (1992) · New England Journal of Medicine · doi:10.1056/nejm199212313272701 · Cited by 964
Diets with high or low protein content and glycemic index for weight-loss maintenance
Larsen, T. M., Dalskov, S.-M., van Baak, M., Jebb, S. A., Papadaki, A., Pfeiffer, A. F. H., Martinez, J. A., Handjieva-Darlenska, T., Kunešová, M., Pihlsgård, M., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1007137 · Cited by 843
Cited by
Sorted by citations
Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914
Taheri, S., Zaghloul, H., Chagoury, O., Elhadad, S., Ahmed, S. H., El Khatib, N., Amona, R. A., El Nahas, K., Suleiman, N., Alnaama, A., et al. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30117-0 · Cited by 393
Bellicha, A., van Baak, M. A., Battista, F., Beaulieu, K., Blundell, J. E., Busetto, L., Carraça, E. V., Dicker, D., Encantado, J., Ermolao, A., et al. (2021) · Obesity Reviews · doi:10.1111/obr.13256 · Cited by 375
“7,27 These results were extracted from five SR-MAs of which four were rated as good or fair quality and three included only RCTs, and therefore provide a reasonably high degree of confidence in this overview's conclusions.”
InfluentialRingen, P. A., Engh, J. A., Birkenaes, A. B., Dieset, I., & Andreassen, O. A. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2014.00137 · Cited by 365
Wright, N., Wilson, L., Smith, M., Duncan, B., & McHugh, P. (2017) · Nutrition & Diabetes · doi:10.1038/nutd.2017.3 · Cited by 340
Metadata
- Authors
- Johansson, K., Neovius, M., & Hemmingsson, E.
- Affiliations
- Karolinska Institutet (SE)
- Corresponding author
- Johansson, Kari
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 99
- Issue
- 1
- Pages
- 14-23
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3862452
- OpenAlex
- W2155231441
- Semantic Scholar
- 3c5db8e0c32c0f2f1fc771ec71ad517c918034ae
- Cited by
- 243
- References
- 47
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 6 · 2023: 19 · 2022: 18 · 2021: 28 · 2020: 18 · 2019: 17 · 2018: 20 · 2017: 27 · 2016: 21 · 2015: 27 · 2014: 24
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- weight loss maintenance, very low calorie diet, hypocaloric diet, anti-obesity drugs, meal replacement, high-protein diet, dietary supplements, physical activity, obesity treatment, weight regain
- MeSH terms
- Energy Intake, Feeding Behavior, Humans, Obesity, Weight Loss, Exercise, Randomized Controlled Trials as Topic, Databases, Factual, Treatment Outcome, Anti-Obesity Agents, Caloric Restriction, Meals
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