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Review
. 2025 Nov;26(11):e13960.
doi: 10.1111/obr.13960. Epub 2025 Jun 3.

Missing the Target: A Scoping Review of the Use of Percent Weight Loss for Obesity Management

Diana Sherifali  1 , Megan Racey  1 , Donna Fitzpatrick-Lewis  1 , Michelle Greenway  1 , Sanjeev Sockalingam  2   3   4 , Jun Wada  5 , Soo Huat Teoh  6 , Ian Patton  2 , David Macklin  3 , Elizabeth F C van Rossum  7 , Luca Busetto  8 , Deborah Bade Horn  9 , J D Patricia Nece  10 , Morgan Emile Gabriel Salmon Leguede  11 , Nicole Pearce  2 , Carel Le Roux  12 , Jamy Ard  13 , Angela S Alberga  14 , Lee Kaplan  15 , Arya M Sharma  16 , Sean Wharton  3
Affiliations
Review

Missing the Target: A Scoping Review of the Use of Percent Weight Loss for Obesity Management

Diana Sherifali et al. Obes Rev. 2025 Nov.

Abstract

Introduction: To co-create comprehensive targets for obesity management, we need to understand the genesis and current use of percent weight loss targets in research. The goals of our scoping review are to (1) synthesize the literature on percent weight loss targets for adults with obesity and (2) discuss the percent weight loss targets in context with their health benefits.

Methods: We searched Cochrane, MEDLINE, and EMBASE for English language, pharmaceutical, and/or behavioral intervention studies in adults with obesity where the explicit aim of the study was weight reduction defined as a percent of body weight. Reviewers screened citations and extracted data including study characteristics.

Results: From 16,164 abstracts, we included 30 citations which were mostly randomized controlled trials (RCTs) (n = 17) or quasi-experimental studies (n = 12) published between 1992 and 2024. Most of the studies had target weight loss goals between 3% and 10% of body weight (n = 28), while n = 2 had body weight loss goals of 15% or 30%. The proportion of participants who met the percent weight loss target ranged from 5.9% (nutrition only study) to 85% (pharmaceutical study). The studies reported different reasons for targeting a percentage of weight loss such as disease-specific outcomes, reduced risk of disease, or patient-reported outcomes.

Conclusion: Percent weight loss targets were based on similar research and were often not feasible nor sustainable for most participants. The design of these interventions and evaluation of obesity management would benefit from more patient-focused parameters which could help to co-design comprehensive targets for research and practice.

Keywords: obesity management; percent body weight; scoping review; target; weight loss.

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Conflict of interest statement

Elisabeth van Rossum: is involved in clinical trials with Rhythm Pharmaceuticals for targeted therapy for rare genetic obesity and served as a speaker for Medcape/WebMD (all payments to the institution, no personal payments).

Soo Huat Teoh: speaking honorariums from Novo Nordisk, Astra Zeneca, iNova Pharmaceuticals, Zuellig Pharma Therapeutics, and Taisho Pharmaceutical Group. Advisory board for iNova Pharmaceuticals and Zuellig Pharma Therapeutics.

Ian Patton: no direct honorarium or relationships but through my role with Obesity Canada. I have served on advisory boards for Novo Nordisk, Boehringer Ingelheim, Eli Lilly, and Pfizer.

Luca Busetto: personal fees for participation in advisory boards for Novonordisk, Eli Lilly, Pfizer, Boehringer‐Ingelheim, and Burno Farmaceutici. Personal fees as speaker for Rythms Pharmaceuticals, and Pronokal.

Deborah Bade Horn: consulting for Amgen, Lilly Inc, and Novo Nordisk. Speaking for Lilly and Novo Nordisk. Clinical research as with all payments to the institution for Lilly and Novonordisk.

Diana Sherifali: has received consulting fees from ICI Medical Communications and has received a speaking honorarium from Novo Nordisk when presenting her research related to health coaching.

Nicole Pearce: is a staff member at Obesity Canada and owns the Global Obesity Learning Centre.

Donna Fitzpatrick‐Lewis: has no conflicts to declare.

Megan Racey: has no conflicts to declare, but her role as a Research Coordinator at McMaster University is funded in part by the Heather M. Arthur Population Health Research Institute/Hamilton Health Sciences Chair in Inter‐Professional Health Research.

Michelle Greenway: has no conflicts to declare related to her role as a PhD student at McMaster University.

Sanjeev Sockalingam: has received honoraria from Bausch Health and Novo Nordisk.

Jun Wada: receives speaker honoraria from Astra Zeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Kyowa Kirin, Novo Nordisk, and Mitsubishi Tanabe and receives grant support from Bayer, Chugai, Kyowa Kirin, Otsuka, Shionogi, Sumitomo, and Mitsubishi Tanabe.

David Macklin: has received honoraria, consulting feeds, and licensing fees for speaking, training, and advisory board positions from Novo Nordisk, Eli Lilly, Boehringer Ingelheim, Rhythm Pharmaceuticals, Shoppers Drug Mart, and Myndset App.

Sean Wharton: has received honoraria and/or serves on advisory boards for Novo Nordisk, Eli Lilly, BI, Astra Zeneca, Amgen, Bausch health Canada, Regeneron, and funding for clinical Trials: Novo Nordisk, Eli Lilly, BI, Astra Zeneca, and Amgen.

Patricia Nece: has received consulting fees from Eli Lilly and Structure Therapeutics.

Morgan Emile Gabriel Salmon Leguede: has no conflicts to declare.

Carel Le Roux: reports grants from the EU Innovative Medicine Initiative, Irish Research Council, Science Foundation Ireland, Anabio, and the Health Research Board. He serves on advisory boards and speakers panels of Novo Nordisk, Roche, Herbalife, GI Dynamics, Eli Lilly, Johnson & Johnson, Gila, Irish Life Health, Boehringer Ingelheim, Currax, Zealand Pharma, Keyron, AstraZeneca, Arrowhead Pharma, Amgen, and Rhythm Pharma. ClR is the Chair of the Irish Society for Nutrition and Metabolism. ClR provides obesity clinical care in the My Best Weight clinic and Beyond BMI clinic and is a co‐owner of these clinics.

Jamy Ard: reports grants from Nestle Healthcare Nutrition, Eli Lilly, Boehringer Ingelheim, Epitomee Inc., UnitedHealth Group R&D, KVK Tech, WW, and Regeneron; has received consulting fees from Nestle Healthcare Nutrition, Eli Lilly, Optum Labs R&D, Novo Nordisk, Intuitive, Regeneron, Brightseed, WW, Amgen, and Boehringer Ingelheim; and receipt of equipment, materials, drugs, medical writing, gifts, or other services from KVK Tech, WW, and Nestle Healthcare Nutrition. Jamy Ard is the President of The Obesity Society and serves as an Executive Board Member for the American Society for Nutrition Foundation.

Angela S. Alberga: has no conflicts to declare.

Lee Kaplan: has been a consultant to Altimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Cytoki, Ethicon, Fractyl, Gelesis, Glyscend, Helicor, Johnson & Johnson, Kallyope, Eli Lilly, MetaVia, Neurogastrx, Novo Nordisk, Optum Health, Perspectum, Pfizer, Rhythm, Sidekick Health, Skye Bioscience, and Zealand.

Arya M. Sharma: has received honoraria as a consultant and/or speaker from Algorithm, AstraZeneca, Boehringer Ingelheim, Currax, Eli Lilly, Johnson & Johnson, and Novo Nordisk.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart adapted from Andrea C. Tricco, Erin Lillie, Wasifa Zarin, et al. PRISMA Extension for Scoping Reviews (PRISMA‐ScR): Checklist and Explanation. Ann Intern Med.2018;169:467‐473. doi:10.7326/M18‐0850.
FIGURE 2
FIGURE 2
Characteristics of included studies and baseline characteristics of participants. (A) Countries of included studies where darker shading represents more studies from this country. (B) Type of intervention. (C) Percent body weight loss targets. (D) Class of obesity of included participants.
See this image and copyright information in PMC

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