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Clinical Question:
Do weight loss interventions improve health-related quality of life?
Bottom Line:
Health-related quality of life (HrQoL) outcomes, including depression, were
not consistently improved in RCTs of weight loss. The overall quality of
these clinical trials was poor. Better-designed RCTs using standardized
HrQoL measures are needed to determine the extent to which weight loss
improves HrQoL.
Reference:
Maciejewski ML, Patrick DL, Williamson DF. A structured review of randomized
controlled trials of weight loss showed little improvement in health-related
quality of life. J Clin Epidemiol 2005;58:568-78.
Study Design:
Systematic review
Setting:
Outpatient
Synopsis:
The author conducted a structured review of 34 RCTs with weight-loss
interventions that reported the relationship between HrQoL and treatment at
two or more time points. We also evaluated study quality. Trials lasted 6
weeks to 208 weeks and evaluated behavioral, surgical, or pharmacologic
interventions. Nine of 34 trials showed HrQoL improvements in generic
measures. Obesity-specific measures were more likely to show improvement in
response to treatment than non-obesity-specific measures. Meta-analysis
showed no treatment effect on depressive symptoms. Most trials tracked loss
to follow-up and conducted intent-to-treat analysis, but only four trials
concealed recruitment staff to randomization and 14 blinded the
investigation team to randomization. |