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Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005

Authors

  • John A. Batsis MD,

    Corresponding author
    1. Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
    2. Weight & Wellness Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
    3. Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire
    4. Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire
    5. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
    6. Health Promotion Research Center at Dartmouth, Lebanon, New Hampshire
    • Address correspondence to John A. Batsis MD, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756. E-mail: john.batsis@gmail.com

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  • Lydia E. Gill BS,

    1. Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire
    2. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
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  • Rebecca K. Masutani BS,

    1. Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire
    2. Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire
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  • Anna M. Adachi-Mejia PhD,

    1. Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire
    2. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
    3. Health Promotion Research Center at Dartmouth, Lebanon, New Hampshire
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  • Heather B. Blunt MSLS,

    1. Biomedical Libraries, Dartmouth College, Hanover, New Hampshire
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  • Pamela J. Bagley PhD, MSLS,

    1. Biomedical Libraries, Dartmouth College, Hanover, New Hampshire
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  • Francisco Lopez-Jimenez MD, MSc,

    1. Division of Cardiovascular Disease, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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  • Stephen J. Bartels MD, MS

    1. Geisel School of Medicine at Dartmouth, Dartmouth College, New Hampshire
    2. Dartmouth Centers for Health and Aging, Dartmouth College, New Hampshire
    3. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
    4. Health Promotion Research Center at Dartmouth, Lebanon, New Hampshire
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Abstract

Objectives

To identify geriatric obesity interventions that can guide clinical recommendations.

Design

Systematic review using Medline (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, EMBASE (Ovid), and PsycINFO (Proquest) from January 1, 2005, to October 12, 2015, to identify English-language randomized controlled trials.

Participants

Individuals aged 60 and older (mean age ≥65) and classified as having obesity (body mass index ≥30 kg/m2).

Interventions

Behavioral weight loss interventions not involving pharmacological or procedural therapies lasting 6 months or longer.

Measurements

Two investigators performed the systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and achieved a high concordance rate (97.3%) in summarizing the primary outcomes. The three primary outcomes were weight loss, physical performance, and quality of life.

Results

Of 5,741 citations, 19 were included. (Six studies were unique, and the remaining 13 were based on the same study population.) Duration ranged from 6 to 18 months (n = 405 participants, age range 66.7–71.1). Weight loss in the intervention groups ranged from 0.5 to 10.7 kg (0.1–9.3%). Five studies had a resistance exercise program accompanying a dietary component. Greater weight loss was observed in groups with a dietary component than those with exercise alone. Exercise alone led to better physical function but no significant weight loss. Combined dietary and exercise components led to the greatest improvement in physical performance measures and quality of life and mitigated reductions in muscle and bone mass observed in diet-only study arms. Heterogeneous outcomes were observed, which limited the ability to synthesize the data quantitatively.

Conclusions

The evidence supporting geriatric obesity interventions to improve physical function and quality of life is of low to moderate quality. Well-designed trials are needed in this population.

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