Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Apr 1;10(4):e0119017.
doi: 10.1371/journal.pone.0119017. eCollection 2015.

Effects of lifestyle interventions that include a physical activity component in class II and III obese individuals: a systematic review and meta-analysis

Aurélie Baillot  1 , Ahmed J Romain  2 , Katherine Boisvert-Vigneault  3 , Mélisa Audet  3 , Jean Patrice Baillargeon  1 , Isabelle J Dionne  3 , Louis Valiquette  4 , Claire Nour Abou Chakra  4 , Antoine Avignon  5 , Marie-France Langlois  1
Affiliations
Meta-Analysis

Effects of lifestyle interventions that include a physical activity component in class II and III obese individuals: a systematic review and meta-analysis

Aurélie Baillot et al. PLoS One. .

Abstract

Background: In class II and III obese individuals, lifestyle intervention is the first step to achieve weight loss and treat obesity-related comorbidities before considering bariatric surgery. A systematic review, meta-analysis, and meta-regression were performed to assess the impact of lifestyle interventions incorporating a physical activity (PA) component on health outcomes of class II and III obese individuals.

Methods: An electronic search was conducted in 4 databases (Medline, Scopus, CINAHL and Sportdiscus). Two independent investigators selected original studies assessing the impact of lifestyle interventions with PA components on anthropometric parameters, cardiometabolic risk factors (fat mass, blood pressure, lipid and glucose metabolism), behaviour modification (PA and nutritional changes), and quality of life in adults with body mass index (BMI) ≥ 35 kg/m2. Estimates were pooled using a random-effect model (DerSimonian and Laird method). Heterogeneity between studies was assessed by the Cochran's chi-square test and quantified through an estimation of the I².

Results: Of the 3,170 identified articles, 56 met our eligibility criteria, with a large majority of uncontrolled studies (80%). The meta-analysis based on uncontrolled studies showed significant heterogeneity among all included studies. The pooled mean difference in weight loss was 8.9 kg (95% CI, 10.2-7.7; p < 0.01) and 2.8 kg/m² in BMI loss (95% CI, 3.4-2.2; p < 0.01). Long-term interventions produced superior weight loss (11.3 kg) compared to short-term (7.2 kg) and intermediate-term (8.0 kg) interventions. A significant global effect of lifestyle intervention on fat mass, waist circumference, blood pressure, total cholesterol, LDL-C, triglycerides and fasting insulin was found (p<0.01), without significant effect on HDL-C and fasting blood glucose.

Conclusions: Lifestyle interventions incorporating a PA component can improve weight and various cardiometabolic risk factors in class II and III obese individuals. However, further high quality trials are needed to confirm this evidence, especially beyond weight loss.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA 2009 Flow Diagram.
Fig 2
Fig 2. Forest plot of mean body mass index changes according to the intervention length in class II and III obese individuals.
Fig 3
Fig 3. Forest plot of mean fat mass changes according to the intervention length in class II and III obese individuals.
Fig 4
Fig 4. Forest plot of mean systolic blood pressure, LDL cholesterol, HDL cholesterol and triglycerides differences according to the intervention length in class II and III obese individuals.
Notes: A (upper corner left): systolic blood pressure; B (upper corner right): LDL cholesterol; C: HDL cholesterol; D: Triglycerides. Letters inserted with the references (b, c, d) represent the different arms of intervention from the same study. A description of each intervention is given in Table 1
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organisation (2014) Obesity and overweight. Fact sheet N°311. Available: http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed 19 August 2014.
    1. Sturm R, Hattori A. Morbid obesity rates continue to rise rapidly in the United States. Int J Obes. 2013;37: 889–891. - PMC - PubMed
    1. Shields M, Carroll MD, Ogden CL. Adult obesity prevalence in Canada and the United States NCHS Data Brief; 2011: 1–8. - PubMed
    1. Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab. 2004;89: 2583–2589. - PubMed
    1. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999;282: 1523–1529. - PubMed

Publication types