Psychological interventions for weight reduction and sustained weight reduction in adults with overweight and obesity: a scoping review

Abstract

Introduction: Overweight and obesity are growing public health problems worldwide. Both diet and physical activity have been the primary interventions for weight reduction over the past decade. With increasing rates of overweight and obesity, it is evident that a primary focus on diet and exercise has not resulted in sustained obesity reduction within the global population. There is now a case to explore other weight management strategies such as psychological therapies. However, there is a dearth of literature that has mapped the types of psychological interventions and the characteristics of these interventions as a means of achieving weight reduction.

Objectives: The key objectives focused on mapping the types and characteristics of psychological interventions versus usual care for weight reduction and sustained weight reduction in adults with overweight or obesity. The study followed the scoping review methodology by Arksey and O'Malley and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Eligibility criteria: Intervention studies were included if participants were 18 years and over, classified as overweight or obese (body mass index ≥25 kg/m²) and had received a psychological therapy intervention. Studies were excluded if they included a comparison with other active lifestyle interventions (unless classified as usual care), were not available in English, were not full-text articles or were non-peer-reviewed articles.

Sources of evidence: Six electronic databases were searched from inception to April 2023 to identify relevant articles.

Charting methods: The study employed a systematic charting method and narrative synthesis to organise and synthesise the data.

Results: A total of 31 studies met the eligibility criteria and were included in the review. 13 unique psychological interventions for weight reduction in adults with overweight or obesity were identified, with cognitive-behavioural therapy and motivational interviewing being the most common. Eight types of usual care were identified, which largely included education and training on nutrition and physical activity. Gaps in the current research were also identified.

Conclusion: The findings highlighted several gaps within the existing literature, largely due to a lack of evidence relating to adults with low socioeconomic status, non-white participants, individuals under 40 years of age and the integration of digital health technologies.

Keywords: Body Mass Index; Health Services; Obesity; PUBLIC HEALTH; Psychological Stress; THERAPEUTICS.

Figure 1. PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Figure 2. Thematic map of types of usual care for weight reduction and sustained weight reduction in adults with overweight or obesity within included studies.