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Self-directed interventions to promote weight loss: a systematic review of reviews

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journal contribution
posted on 18.02.2016, 11:26 by J. Tang, C. Abraham, C. Greaves, Tom Yates
BACKGROUND: A wide range of self-directed weight-loss interventions are available, providing users with a variety of tools delivered through various formats to regulate weight-related behavior patterns. However, it is unclear how effective self-directed interventions are and how they promote weight loss and weight maintenance. OBJECTIVE: A systematic review of reviews was conducted to examine the effectiveness of such interventions and to identify intervention content associated with effectiveness. METHODS: MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library for systematic reviews were searched from 2000-2012 for reviews of the effectiveness of self-directed interventions on weight loss and weight maintenance in adults. Two reviewers used predefined inclusion criteria to select relevant reviews and assess their quality using the Overview Quality Assessment Questionnaire (OQAQ). We extracted data on effectiveness and on relationships between intervention characteristics and effectiveness. RESULTS: Twenty reviews were included and quality assessed. Findings relevant to self-directed interventions, including interactive websites, smartphone applications, and text messaging (short message service, SMS) were summarized. Findings were mixed but promising. For example, one review of Internet-based interventions found that, when used in conjunction with standard weight loss programs, these interventions resulted in a significant average increase in weight loss of 1.5 kg over evaluation periods. Unfortunately, only 7 of 20 reviews were of high methodological quality according to OQAQ scores, and only 4 employed meta-analyses. Few reviews linked intervention content to effectiveness. CONCLUSIONS: Current evidence suggests that self-directed interventions can independently promote weight loss and can augment interventions involving personal contact. Particular change techniques and delivery modes including individualized feedback, email counseling, and online social support appear to enhance effectiveness. Further reviews of the content of self-directed weight-loss intervention studies are needed to clarify which change techniques delivered through which delivery formats optimize intervention effectiveness.

Funding

The work was partially funded by the UK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC)

History

Citation

Journal of Medical Internet Research, 2014;16(2):e58

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine

Version

AM (Accepted Manuscript)

Published in

Journal of Medical Internet Research

Publisher

Journal of Medical Internet Research

issn

1439-4456

eissn

1438-8871

Acceptance date

21/12/2013

Copyright date

2014

Available date

18/02/2016

Publisher version

http://www.jmir.org/2014/2/e58/

Notes

PMCID: 3961624

Language

en