Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis.

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metabolic syndrome 2 endocrinologydiseases
metformin 2 endocrinologydiseasesdrugs
obesity 23 endocrinologydiseases
orlistat 1 endocrinologydiseasesdrugs

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Select Drug Character Offset Drug Term Instance
metformin 16215 calories from fat, low saturated fat, for 7% weight loss) and exercise programmeGroup 2—Control and metformin placeboFinnish DPS, 2009, Finland[3][48][49]52316.4138Impaired glucose tolerance55.2 (7.2)677White31.3
metformin 21173 1—Diet (low calorie, low fat) and exercise adviceGroup 2—Diet as above and exercise advice and metformin Group 3—ControlGroup 4—MetforminRejeski, 2011, USA (CLIP)[76]28813.518Recent cardiovascular disease,
orlistat 23956 counselling)Group 2—Diet based on DPP (1200-1800 kcal/d, 20-35% calories from fat; meal replacements, orlistat or sibutramine if required) and exercise advice (enhanced counselling)Group 3—ControlWing, 2010, USA
Select Disease Character Offset Disease Term Instance
metabolic syndrome 19350 replacements) and exercise programmeGroup 2—ControlMa, 2013, USA[67]24134.424Impaired fasting glucose or metabolic syndrome 52.9 (10.6)47NRWhite32.0 (5.4)Group 1—Diet based on DPP (500-1000 kcal/d deficit, 25% calories from
metabolic syndrome 21287 3—ControlGroup 4—MetforminRejeski, 2011, USA (CLIP)[76]28813.518Recent cardiovascular disease, metabolic syndrome , or mobility limitation67.1 (4.8)67NRWhite32.8 (3.8)Group 1—Diet based on DGA (1200-1800 kcal/d, low
obesity 591 date (epub): 11/2017AbstractObjective To assess whether weight loss interventions for adults with obesity affect all cause, cardiovascular, and cancer mortality, cardiovascular disease, cancer, and body weight.Design Systematic
obesity 1330 interventions targeting weight loss, with or without exercise advice or programmes, for adults with obesity and follow-up ≥1 year.Results 54 RCTs with 30 206 participants were identified. All but one trial
obesity 2640 with or without exercise advice or programmes, may reduce premature all cause mortality in adults with obesity .Systematic review registration PROSPERO CRD42016033217.IntroductionAdults with obesity have an increased
obesity 2728 adults with obesity.Systematic review registration PROSPERO CRD42016033217.IntroductionAdults with obesity have an increased risk of premature mortality, cardiovascular disease, some cancers, type 2 diabetes,
obesity 2930 diabetes, and many other diseases.[1][2] These associations inform the need for programmes to prevent obesity , but, apart from prevention of type 2 diabetes,[3][4] limited evidence from randomised controlled trials
obesity 3128 controlled trials (RCTs) shows that weight loss interventions can prevent serious harm for people with obesity . Evidence from cohort studies has led to debate that deliberate weight loss for people who are overweight
obesity 3778 lowest at BMIs of 20-25.[8]Association studies cannot tell us if deliberate weight loss in adults with obesity can reduce their risk of premature mortality, cardiovascular disease, or cancer. Only one systematic
obesity 3962 cancer. Only one systematic review and meta-analysis of RCTs of intentional weight loss in adults with obesity has examined this question.[9] That review included 15 trials, reporting a 15% relative reduction in
obesity 4409 cardiovascular outcomes, from our database of long term RCTs of weight loss interventions for adult obesity , which was developed for health technology assessments[10][11] and is continually updated. We systematically
obesity 4607 We systematically reviewed long term (≥1 year) RCTs of weight loss interventions for adults with obesity to examine the effects of any type of weight loss diet on all cause, cardiovascular, and cancer mortality,
obesity 6226 reports in our database of all long term (≥1 year) RCTs of weight loss interventions for adults with obesity used in our previous systematic reviews and health technology assessments. Our database is derived from
obesity 9276 we added trials in any Asian population group if the mean BMI was ≥25, as diseases associated with obesity are known to occur at lower BMI in Asian populations than other ethnic groups.[21] No single BMI cut-off
obesity 9415 in Asian populations than other ethnic groups.[21] No single BMI cut-off has been agreed to define obesity in Asian populations. Although the World Health Organization recommends 27.5 as a BMI threshold for
obesity 9639 comorbidities,[21] it also suggests that Asian countries develop their own specific BMI cut-offs for obesity . India and Japan have set ≥25 as the threshold for obesity,[22][23] and in China the risk of comorbidities
obesity 9700 develop their own specific BMI cut-offs for obesity. India and Japan have set ≥25 as the threshold for obesity ,[22][23] and in China the risk of comorbidities has been found to increase for BMI over 28.[24]For all
obesity 11332 1 Study selectionTable 1 provides details of the included studies, involving 30 206 adults with obesity . Nine trials (16.7%) included women only,[26][44][45][50][51][52][77][88][94] and two (3.7%) men only.[58][72]
obesity 11610 reported existing medical conditions or no reported increased risk of developing comorbidities related to obesity . Other trials recruited participants with increased risk of type 2 diabetes or hypertension or included
obesity 35445 activity advice.DiscussionWe found high quality evidence that weight reducing diets for adults with obesity , usually low in fat and low in saturated fat, were associated with a 18% relative reduction in premature
obesity 36505 from 48 trialists. We used a comprehensive search strategy with full text searching of trials in our obesity database. The trials we included were not necessarily designed to collect data on mortality, cardiovascular,
obesity 38212 compared with BMIs of 18.5 to <25.[5] By contrast, the Global BMI Mortality Collaboration found that obesity (BMI 30 to <35) was associated with higher mortality; the investigators reduced reverse causality by
obesity 38838 Epidemiological studies can demonstrate the risks of higher BMIs and, therefore, the necessity for preventing obesity , but epidemiological associations between changes in body weight and changes in disease and mortality
obesity 39745 attend, for which we had limited statistical power. The majority of RCTs of weight loss interventions for obesity in adults have used low fat, weight reducing diets. But a recent systematic review by Tobias and colleagues[101]
obesity 41204 the interventions.[104] Collecting and reporting major disease outcomes in weight reducing trials for obesity is important, particularly cardiovascular disease and cancer. We did not have sufficient data to examine

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