Objective To examine the effectiveness of behavioural weight management interventions for adults with obesity delivered in primary care. Design Systematic review and meta-analysis of randomised controlled trials. Eligibility criteria for selection of studies Randomised controlled trials of behavioural weight management interventions for adults with a body mass index ≥25 delivered in primary care compared with no treatment, attention control, or minimal intervention and weight change at ≥12 months follow-up. Data sources Trials from a previous systematic review were extracted and the search completed using the Cochrane Central Register of Controlled Trials, Medline, PubMed, and PsychINFO from 1 January 2018 to 19 August 2021. Data extraction and synthesis Two reviewers independently identified eligible studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tool. Meta-analyses were conducted with random effects models, and a pooled mean difference for both weight (kg) and waist circumference (cm) were calculated. Main outcome measures Primary outcome was weight change from baseline to 12 months. Secondary outcome was weight change from baseline to ≥24 months. Change in waist circumference was assessed at 12 months. Results 34 trials were included: 14 were additional, from a previous review. 27 trials (n=8000) were included in the primary outcome of weight change at 12 month follow-up. The mean difference between the intervention and comparator groups at 12 months was −2.3 kg (95% confidence interval −3.0 to −1.6 kg, I2=88%, P<0.001), favouring the intervention group. At ≥24 months (13 trials, n=5011) the mean difference in weight change was −1.8 kg (−2.8 to −0.8 kg, I2=88%, P<0.001) favouring the intervention. The mean difference in waist circumference (18 trials, n=5288) was −2.5 cm (−3.2 to −1.8 cm, I2=69%, P<0.001) in favour of the intervention at 12 months. Conclusions Behavioural weight management interventions for adults with obesity delivered in primary care are effective for weight loss and could be offered to members of the public. Systematic review registration PROSPERO CRD42021275529. Additional data are available in the supplementary files.

中文翻译：

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初级保健中成人体重管理干预措施的有效性：随机对照试验的系统评价和荟萃分析

目的检查行为体重管理干预对初级保健中肥胖成人的有效性。设计 随机对照试验的系统评价和荟萃分析。选择研究的资格标准 体重指数≥25 的成人在初级保健中进行的行为体重管理干预的随机对照试验与在≥12 个月的随访中未进行治疗、注意力控制或最小干预和体重变化进行比较。数据来源 2018 年 1 月 1 日至 2021 年 8 月 19 日期间，提取了来自先前系统评价的试验，并使用 Cochrane 对照试验中央注册库、Medline、PubMed 和 PsychINFO 完成了搜索。数据提取和合成 两名评价员独立确定符合条件的研究，提取数据，并使用 Cochrane 偏倚风险工具评估偏倚风险。使用随机效应模型进行荟萃分析，计算体重（kg）和腰围（cm）的汇总平均差。主要结果测量 主要结果是从基线到 12 个月的体重变化。次要结果是体重从基线变化到≥24个月。在 12 个月时评估腰围的变化。结果 纳入了 34 项试验：14 项是额外的，来自先前的审查。27 项试验（n=8000）被纳入 12 个月随访时体重变化的主要结果。干预组和对照组在 12 个月时的平均差异为 -2.3 kg（95% 置信区间 -3.0 至 -1.6 kg，I2=88%，P<0.001），有利于干预组。≥24 个月时（13 项试验，n = 5011）体重变化的平均差异为-1.8 kg（-2.8至-0.8 kg，I2 = 88％，P<0.001）有利于干预。腰围的平均差异（18 项试验，n=5288）为 -2.5 cm（-3.2 至 -1.8 cm，I2=69%，P<0.001），有利于 12 个月时的干预。结论 初级保健中针对肥胖成人的行为体重管理干预措施可有效减轻体重，并可提供给公众。系统评价注册 PROSPERO CRD42021275529。补充文件中提供了其他数据。结论 初级保健中针对肥胖成人的行为体重管理干预措施可有效减轻体重，并可提供给公众。系统评价注册 PROSPERO CRD42021275529。补充文件中提供了其他数据。结论 初级保健中针对肥胖成人的行为体重管理干预措施可有效减轻体重，并可提供给公众。系统评价注册 PROSPERO CRD42021275529。补充文件中提供了其他数据。