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
. 2017 Nov;40(6):783-794.
doi: 10.1080/10790268.2017.1370207. Epub 2017 Sep 20.

Management of obesity after spinal cord injury: a systematic review

Mir Hatef Shojaei  1 , Seyed Mohammad Alavinia  1 , B Catharine Craven  1   2
Affiliations

Management of obesity after spinal cord injury: a systematic review

Mir Hatef Shojaei et al. J Spinal Cord Med. 2017 Nov.

Abstract

Context: Individuals with chronic spinal cord injury (SCI) are susceptible to central and visceral obesity and it's metabolic consequences; consensus based guidelines for obesity management after SCI have not yet been stablished.

Objectives: To identify and compare effective means of obesity management among SCI individuals.

Methods: This systematic review included English and non-English articles, published prior to April 2017 found in the PubMed/Medline, Embase, CINAHL Psychinfo and Cochrane databases. Studies evaluating any obesity management strategy, alone or in combination, including: diet therapy, voluntary and involuntary exercise such as neuro-muscular electric stimulation (NMES), pharmacotherapy, and surgery, among individuals with chronic SCI were included. Outcomes of interest were reductions in waist circumference, body weight (BW), body mass index (BMI) and total fat mass (TFM) and increases in total lean body mass (TLBM) from baseline. From 3,553 retrieved titles and abstracts, 34 articles underwent full text review and 23 articles were selected for data abstraction. Articles describing weight loss due to inflammation, cancer or B12 deficiency were excluded. The Downs and Black reported poor to moderate quality of the studies.

Results: Bariatric surgery produced the greatest permanent weight reduction and BMI correction followed by combinations of physical exercise and diet therapy. Generally, NMES and pharmacotherapy improved TLBM and reduced TFM but not weight.

Conclusions: The greatest weight reduction and BMI correction was produced by bariatric surgery, followed by a combination of physical exercise and diet therapy. NMES and pharmacologic treatment did not reduce weight or TFM but increased in TLBM.

Keywords: Body composition; Management; Obesity; Spinal cord injury.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
PRISMA Flow Diagram – study selection process.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Buchholz AC, McGillivray CF, Pencharz PB.. Differences in resting metabolic rate between paraplegic and able-bodied subjects are explained by differences in body composition. Am J Clin Nutr 2003 Feb;77(2):371–8. - PubMed
    1. Rajan S, McNeely MJ, Warms C, Goldstein B.. Clinical assessment and management of obesity in individuals with spinal cord injury: a review. J Spinal Cord Med 2008;31(4):361–72. - PMC - PubMed
    1. Gater DR., Jr Obesity after spinal cord injury. Phys Med Rehabil Clin N Am 2007 May;18(2):333–514. - PubMed
    1. Rush EC, Goedecke JH, Jennings C, Micklesfield L, Dugas L, Lambert EV, et al. BMI, fat and muscle differences in urban women of five ethnicities from two countries. Int J Obes (Lond) 2007;31(8):1232–9. - PubMed
    1. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Am J Clin Nutr 1998;68(4):899–917. - PubMed

Publication types

LinkOut - more resources