SynthesisJournal of general internal medicine2009
Treatment of obesity in primary care practice in the United States: a systematic review.
Synthesis in Journal of general internal medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02893163 (CHANGE), which is not on this map. Cited by 108 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
CHANGE (Canadian Health Advanced by Nutrition and Graded Exercise) Cancer Alberta: A Primary Care Program for Cancer Prevention and Screening
Who cites it
108 citing papers in PubMed, 8 syntheses or guidelines pooled it, 223 citations in OpenAlex.
- A systematic review of lifestyle counseling for diverse patients in primary care.Preventive medicine · 2017Pooled it
- Cognitive and behavioural strategies for self-directed weight loss: systematic review of qualitative studies.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2017Pooled it
- An Evidence-based Guide for Obesity Treatment in Primary Care.The American journal of medicine · 2016Guideline
- A systematic review of motivational interviewing for weight loss among adults in primary care.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2015Pooled it
- Self-help for weight loss in overweight and obese adults: systematic review and meta-analysis.American journal of public health · 2015Pooled it
- Technology-assisted weight loss interventions in primary care: a systematic review.Journal of general internal medicine · 2015Pooled it
- Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis.Family practice · 2014Pooled it
- A systematic review of behavioural weight-loss interventions involving primary-care physicians in overweight and obese primary-care patients (1999-2011).Public health nutrition · 2013Pooled it
- A cluster-randomized controlled trial of automated internet weight-loss programs in primary care: Role of automated provider feedback.Obesity (Silver Spring, Md.) · 2022Trial
- Recruitment and reach in a pragmatic behavioral weight loss randomized controlled trial: implications for real-world primary care practice.BMC family practice · 2020Trial
- Computerized neurocognitive training for improving dietary health and facilitating weight loss.Journal of behavioral medicine · 2019Trial
- Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET): pragmatic randomised controlled trial.BMJ (Clinical research ed.) · 2018Trial
- Two-Year Results of Think Health! ¡Vive Saludable!: A Primary Care Weight-Management Trial.Obesity (Silver Spring, Md.) · 2018Trial
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- A Randomized Clinical Trial of a Tailored Lifestyle Intervention for Obese, Sedentary, Primary Care Patients.Annals of family medicine · 2016Trial
- Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients.Contemporary clinical trials · 2016Trial
- Challenges in interdisciplinary weight management in primary care: lessons learned from the 5As Team study.Clinical obesity · 2016Trial
- Physician versus non-physician delivery of alcohol screening, brief intervention and referral to treatment in adult primary care: the ADVISe cluster randomized controlled implementation trial.Addiction science & clinical practice · 2015Trial
- Satisfaction with primary care provider involvement is associated with greater weight loss: Results from the practice-based POWER trial.Patient education and counseling · 2015Trial
48 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesThis review examines the results of randomized controlled trials in which behavioral weight loss interventions, used alone or with pharmacotherapy, were provided in primary care settings. DATA SOURCES: Literature search of MEDLINE, PubMed, Cochrane Systematic Reviews, CINAHL, and EMBASE (1950-present). Inclusion criteria for studies were: (1) randomized trial, (2) obesity intervention in US adults, and (3) conducted in primary care or explicitly intended to model a primary care setting. REVIEW
methodsBoth authors reviewed each study to extract treatment modality, provider, setting, weight change, and attrition. The CONSORT criteria were used to assess study quality. Due to the small number and heterogeneity of studies, results were summarized but not pooled quantitatively.
resultsTen trials met the inclusion criteria. Studies were classified as: (1) PCP counseling alone, (2) PCP counseling + pharmacotherapy, and (3) "collaborative" obesity care (treatment delivered by a non-physician provider). Weight losses in the active treatment arms of these categories of studies ranged from 0.1 to 2.3 kg, 1.7 to 7.5 kg, and 0.4 to 7.7 kg, respectively. Most studies provided low- or moderate-intensity counseling, as defined by the US Preventive Services Task Force.
conclusionsCurrent evidence does not support the use of low- to moderate-intensity physician counseling for obesity, by itself, to achieve clinically meaningful weight loss. PCP counseling plus pharmacotherapy, or intensive counseling (from a dietitian or nurse) plus meal replacements may help patients achieve this goal. Further research is needed on different models of managing obesity in primary care practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.