obesity treatment and counselling

Dietary counselling is a short term solution to obesity
Dietary counselling is the mainstay of many weight loss programmes. To measure how well this works in practice a meta-analysis of 16 randomised controlled trials was made in the USA (Ann Intern Med 2007; vol 147 pp :41-50. Forty two of the trials included exercise as part of the programme. When compared with what they described as usual care, dietary counselling helped overweight and obese people lose just under two units of body mass index, or 6% of their initial body weight in one year. But weight increased once counselling finished. They regained about half their initial weight loss in three years. Weight gain accelerated towards the end of follow up, starting with 0.02 to 0.03 units of body mass index a month between 12 and 18 months and increasing to 0.04 units a month between 24 and 30 months.
Whether these small benefits make a lasting difference to people’s risk of cardiovascular events or death is unclear. The researchers found no trials of dietary counselling with clinically useful end points.
The trials were generally of average or poor quality and tested a mixed bag of interventions. So there’s likely to be some uncertainty around the final combined result.

Martin Eastwood
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