Weight Management Interventions Provided by a Dietitian for Adults with Overweight or Obesity: An Evidence Analysis Center Systematic Review and Meta-Analysis

Maria Morgan-Bathke; Suzanne Domel Baxter; Tanya M Halliday; Amanda Lynch; Neal Malik; Hollie A Raynor; Jessica L Garay; Mary Rozga

doi:10.1016/j.jand.2022.03.014

Weight Management Interventions Provided by a Dietitian for Adults with Overweight or Obesity: An Evidence Analysis Center Systematic Review and Meta-Analysis

J Acad Nutr Diet. 2023 Nov;123(11):1621-1661.e25. doi: 10.1016/j.jand.2022.03.014. Epub 2022 Jul 1.

Authors

Maria Morgan-Bathke¹, Suzanne Domel Baxter², Tanya M Halliday³, Amanda Lynch⁴, Neal Malik⁵, Hollie A Raynor⁶, Jessica L Garay⁷, Mary Rozga⁸

Affiliations

¹ Department of Nutrition and Dietetics, Viterbo University, La Crosse, WI.
² College of Social Work, University of South Carolina, Columbia, SC.
³ Department of Health and Kinesiology, University of Utah, Salt Lake City, UT.
⁴ Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI.
⁵ Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, CA.
⁶ College of Education, Health, and Human Sciences, University of Tennessee Knoxville, Knoxville, TN.
⁷ Department of Nutrition and Food Studies, Syracuse University, Syracuse NY.
⁸ Academy of Nutrition and Dietetics, Chicago, IL. Electronic address: mrozga@eatright.org.

PMID: 35788061
DOI: 10.1016/j.jand.2022.03.014

Abstract

Background: Obesity is associated with a multitude of comorbidities and considerable health care costs.

Objective: The objective of this review was to examine the efficacy of weight management interventions provided by a registered dietitian or international equivalent (referred to as "dietitian").

Methods: This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of weight management interventions provided by a dietitian, compared with usual care or no intervention, on several cardiometabolic outcomes and quality of life in adults with overweight or obesity. MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and CINAHL databases were searched for eligible RCTs published between January 2008 and January 2021 in the English language. Meta-analyses were conducted using a random-effects model, publication bias was assessed using funnel plots and Egger's statistics, and heterogeneity was assessed by interpreting I² values. Efficacy of intervention components, such as telehealth or group contacts, were explored in sub-group analyses. Version 2 of the risk-of-bias tool for RCTs was used to assess risk of bias. The Grading of Recommendations Assessment, Development and Evaluation method was used to determine certainty of evidence.

Results: This systematic review included 62 RCTs. Compared with control conditions, weight management interventions provided by a dietitian resulted in improved body mass index (mean difference [MD] -1.5; 95% CI -1.74 to -1.26; moderate evidence certainty); percent weight loss (MD -4.01%; 95% CI -5.26% to -2.75%; high evidence certainty); waist circumference (MD -3.45 cm; 95% CI -4.39 to -2.51 cm; high evidence certainty); blood pressure (MD -3.04 mm Hg; 95% CI -5.10 to -0.98 mm Hg and MD -1.99 mm Hg; 95% CI -3.02 to -0.96 mm Hg for systolic blood pressure and diastolic blood pressure, respectively; moderate and low evidence certainty); and quality of life using the 36-Item Short Form Survey (MD 5.84; 95% CI 2.27 to 9.41 and 2.39; 95% CI 1.55 to 3.23 for physical and mental quality of life, respectively; low and moderate evidence certainty).

Conclusions: For adults with overweight or obesity, weight management interventions provided by a dietitian are efficacious for improving several examined cardiometabolic outcomes and quality of life.