Interventions in obesity treatments: a systematic review

Abstract

Objective: to make a systematic review to evaluate the effectiveness and safety of methods to reduce weight, as follows: surgical, pharmacological and changes in lifestyle, which include exercise and diet. Clinical outcomes of interest were weight loss and long-term loss maintenance. Methods: a search for the keywords “weight loss maintenance” and “obesity treatment” in articles from PubMed, Scielo and Cochrane Library database was performed. The search included articles in English, Portuguese and Spanish published until October 2011. Systematic reviews, meta-analysis and randomized clinical trials that had a follow-up period greater or equal to one year were included. The studies should have obese adults (over 18 years with body mass index greater than 30) as participants and compare different interventions to the treatment of obesity. Results: five articles that fulfill the inclusion criteria were selected, and each of these articles separately studied the effectiveness of Orlistat, Sibutramine, Pramlintide and gastroplasty, in comparison to changes in lifestyle. Gastroplasty presented significant results (p < 0.05) to avoid the total weight regain. Orlistat produced significant weight loss during the first year of treatment and weight gain was reduced with its use in the second year of treatment (p < 0.001). Sibutramine was effective in maintaining weight loss after a weight loss diet with high caloric restriction. Pramlintide showed effectiveness in weight loss and reduction in waist circumference. Conclusions: Pharmacological and surgical interventions were more effective compared to changes in lifestyle regarding weight loss and maintenance in the long term, but further studies need to be carried out to examine the comparison between the different interventions available for the treatment of obesity.