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. 2021 Jul;22(7):e13218.
doi: 10.1111/obr.13218. Epub 2021 Feb 23.

Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review and network meta-analysis

Jakub Morze  1   2 , Gerta Rücker  3 , Anna Danielewicz  2 , Katarzyna Przybyłowicz  2 , Manuela Neuenschwander  4 , Sabrina Schlesinger  4 , Lukas Schwingshackl  5
Affiliations

Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review and network meta-analysis

Jakub Morze et al. Obes Rev. 2021 Jul.

Abstract

Obesity management guidelines consistently advise aerobic training for weight loss, whereas recommendations for other training modalities are sparse. This systematic review and network meta-analysis (NMA) aimed to compare the long-term effects of different training modalities on anthropometric outcomes in patients with obesity. MEDLINE, Cochrane CENTRAL, and Web of Science were searched to identify the following: (1) randomized controlled trials (RCTs); (2) conducted in adults with a mean body mass index (BMI) ≥30 kg/m2 ; (3) comparing aerobic, resistance, combined, or high-intensity interval training head-to-head or to control for ≥6 months; and (4) reporting changes in body weight (BW), BMI, waist circumference (WC), fat mass (FM), or fat-free mass (FFM). Random-effects NMA models were fitted in a frequentist approach. GRADE framework was used to assess certainty of evidence. Thirty-two RCTs with 4774 participants with obesity were included in this review. Aerobic training was ranked as best for improving BW, BMI, and WC and combined training for improving FM, as well as equally with resistance training most effective for improving FFM. Low to moderate certainty of evidence supports use of aerobic training to improve anthropometric outcomes in obesity, and its combination with resistance training provides additional benefit for reducing FM and increasing FFM.

Keywords: GRADE; aerobic exercise; network meta-analysis; resistance exercise.

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Conflict of interest statement

J.M, G.R., A.D., K.P., M.N., S.S., and L.S. declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of the search and study selection process
FIGURE 2
FIGURE 2
Net graphs for (A) body weight, (B) body mass index, (C) waist circumference, (D) fat mass, and (E) fat‐free mass. The size of the nodes is proportional to the total number of participants allocated to exercise modality, and the thickness of the lines is proportional to the number of studies evaluating each direct comparison. AET, aerobic exercise training; CT, combined training; MI, minimal intervention; RT, resistance training
FIGURE 3
FIGURE 3
Interval plot summarizing mean difference with 95% confidence interval for (A) body weight, (B) body mass index, (C) waist circumference, (D) fat mass, and (E) fat‐free mass as estimated from the network meta‐analysis for every possible pair of training modality. Negative values favor intervention on the left side. AET, aerobic exercise training; CONT, control; CT, combined training; MI, minimal intervention; RT, resistance training
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