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

doi:10.1111/obr.13960

Review

. 2025 Jun 3:e13960.

doi: 10.1111/obr.13960. Online ahead of print.

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

Diana Sherifali¹, Megan Racey¹, Donna Fitzpatrick-Lewis¹, Michelle Greenway¹, Sanjeev Sockalingam^{2

3

4}, Jun Wada⁵, Soo Huat Teoh⁶, Ian Patton², David Macklin³, Elizabeth F C van Rossum⁷, Luca Busetto⁸, Deborah Bade Horn⁹, J D Patricia Nece¹⁰, Morgan Emile Gabriel Salmon Leguede¹¹, Nicole Pearce², Carel Le Roux¹², Jamy Ard¹³, Angela S Alberga¹⁴, Lee Kaplan¹⁵, Arya M Sharma¹⁶, Sean Wharton³

Affiliations

¹ McMaster Evidence Review and Synthesis Team; School of Nursing, McMaster University, Hamilton, Ontario, Canada.
² Obesity Canada, Edmonton, Alberta, Canada.
³ Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁴ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁵ Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
⁶ Department of Clinical Medicine, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia.
⁷ Department of Internal Medicine, Division of Endocrinology, and Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
⁸ Department of Medicine, University of Padova, Padova, Italy.
⁹ Center of Obesity Medicine and Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School, Houston, Texas, USA.
¹⁰ Obesity Action Coalition, Tampa, Florida, USA.
¹¹ ABHispalis Spain, Alianza Hispana de Personas con Obesidad Latin America, Seville, Spain.
¹² School of Medicine, University College Dublin, Dublin, Ireland.
¹³ School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
¹⁴ Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada.
¹⁵ Obesity, Metabolism and Nutrition Institute Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
¹⁶ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

PMID: 40461407
DOI: 10.1111/obr.13960

Review

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

Diana Sherifali et al. Obes Rev. 2025.

. 2025 Jun 3:e13960.

doi: 10.1111/obr.13960. Online ahead of print.

Authors

Affiliations

¹ McMaster Evidence Review and Synthesis Team; School of Nursing, McMaster University, Hamilton, Ontario, Canada.
² Obesity Canada, Edmonton, Alberta, Canada.
³ Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁴ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁵ Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
⁶ Department of Clinical Medicine, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia.
⁷ Department of Internal Medicine, Division of Endocrinology, and Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
⁸ Department of Medicine, University of Padova, Padova, Italy.
⁹ Center of Obesity Medicine and Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School, Houston, Texas, USA.
¹⁰ Obesity Action Coalition, Tampa, Florida, USA.
¹¹ ABHispalis Spain, Alianza Hispana de Personas con Obesidad Latin America, Seville, Spain.
¹² School of Medicine, University College Dublin, Dublin, Ireland.
¹³ School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
¹⁴ Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada.
¹⁵ Obesity, Metabolism and Nutrition Institute Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
¹⁶ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

PMID: 40461407
DOI: 10.1111/obr.13960

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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References

1. D. B. Horn, J. P. Almandoz, and M. Look, “What Is Clinically Relevant Weight Loss for Your Patients and How Can It Be Achieved? A Narrative Review,” Postgraduate Medicine 134, no. 4 (2022): 359–375, https://doi.org/10.1080/00325481.2022.2051366.
1. F. Magkos, E. Nikonova, R. Fain, S. Zhou, T. Ma, and W. Shanahan, “Effect of Lorcaserin on Glycemic Parameters in Patients With Type 2 Diabetes Mellitus,” Obesity (Silver Spring) 25, no. 5 (2017): 842–849, https://doi.org/10.1002/oby.21798.
1. J. P. H. Wilding, R. L. Batterham, S. Calanna, et al., “Once‐Weekly Semaglutide in Adults With Overweight or Obesity,” New England Journal of Medicine Mar 18, 384, no. 11 (2021): 989–1002, https://doi.org/10.1056/NEJMoa2032183.
1. V. Yumuk, C. Tsigos, M. Fried, et al., “European Guidelines for Obesity Management in Adults,” Obesity Facts 8, no. 6 (2015): 402–424, https://doi.org/10.1159/000442721.
1. C. W. le Roux, A. Astrup, K. Fujioka, et al., “3 Years of Liraglutide Versus Placebo for Type 2 Diabetes Risk Reduction and Weight Management in Individuals With Prediabetes: A Randomised, Double‐Blind Trial,” Lancet 389, no. 10077 (2017): 1399–1409, https://doi.org/10.1016/s0140‐6736(17)30069‐7.

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[1] D. B. Horn, J. P. Almandoz, and M. Look, “What Is Clinically Relevant Weight Loss for Your Patients and How Can It Be Achieved? A Narrative Review,” Postgraduate Medicine 134, no. 4 (2022): 359–375, https://doi.org/10.1080/00325481.2022.2051366.

[2] D. B. Horn, J. P. Almandoz, and M. Look, “What Is Clinically Relevant Weight Loss for Your Patients and How Can It Be Achieved? A Narrative Review,” Postgraduate Medicine 134, no. 4 (2022): 359–375, https://doi.org/10.1080/00325481.2022.2051366.

[3] F. Magkos, E. Nikonova, R. Fain, S. Zhou, T. Ma, and W. Shanahan, “Effect of Lorcaserin on Glycemic Parameters in Patients With Type 2 Diabetes Mellitus,” Obesity (Silver Spring) 25, no. 5 (2017): 842–849, https://doi.org/10.1002/oby.21798.

[4] F. Magkos, E. Nikonova, R. Fain, S. Zhou, T. Ma, and W. Shanahan, “Effect of Lorcaserin on Glycemic Parameters in Patients With Type 2 Diabetes Mellitus,” Obesity (Silver Spring) 25, no. 5 (2017): 842–849, https://doi.org/10.1002/oby.21798.

[5] J. P. H. Wilding, R. L. Batterham, S. Calanna, et al., “Once‐Weekly Semaglutide in Adults With Overweight or Obesity,” New England Journal of Medicine Mar 18, 384, no. 11 (2021): 989–1002, https://doi.org/10.1056/NEJMoa2032183.

[6] J. P. H. Wilding, R. L. Batterham, S. Calanna, et al., “Once‐Weekly Semaglutide in Adults With Overweight or Obesity,” New England Journal of Medicine Mar 18, 384, no. 11 (2021): 989–1002, https://doi.org/10.1056/NEJMoa2032183.

[7] V. Yumuk, C. Tsigos, M. Fried, et al., “European Guidelines for Obesity Management in Adults,” Obesity Facts 8, no. 6 (2015): 402–424, https://doi.org/10.1159/000442721.

[8] V. Yumuk, C. Tsigos, M. Fried, et al., “European Guidelines for Obesity Management in Adults,” Obesity Facts 8, no. 6 (2015): 402–424, https://doi.org/10.1159/000442721.

[9] C. W. le Roux, A. Astrup, K. Fujioka, et al., “3 Years of Liraglutide Versus Placebo for Type 2 Diabetes Risk Reduction and Weight Management in Individuals With Prediabetes: A Randomised, Double‐Blind Trial,” Lancet 389, no. 10077 (2017): 1399–1409, https://doi.org/10.1016/s0140‐6736(17)30069‐7.

[10] C. W. le Roux, A. Astrup, K. Fujioka, et al., “3 Years of Liraglutide Versus Placebo for Type 2 Diabetes Risk Reduction and Weight Management in Individuals With Prediabetes: A Randomised, Double‐Blind Trial,” Lancet 389, no. 10077 (2017): 1399–1409, https://doi.org/10.1016/s0140‐6736(17)30069‐7.

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

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

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Abstract

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