Evidence map›Paper›PMID 40791268›Full record

ArticleBMJ public health2025

Are there inequalities in the attendance at and effectiveness of behavioural weight management interventions for adults in the UK? An individual participant data meta-analysis.

Jack M Birch, Julia Mueller, Sarah Damery, Stephen J Sharp, Rebecca A Jones, Michael P Kelly, Annie S Anderson, Nerys Astbury, Paul Aveyard, Rebecca J Beeken and 9 more

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In one paragraph

Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Jack M BirchMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.ORCID https://orcid.org/0000-0001-6292-1647
Julia MuellerMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Sarah DameryInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Stephen J SharpMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Rebecca A JonesMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Michael P KellyDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Annie S AndersonSchool of Medicine, University of Dundee, Dundee, UK.
Nerys AstburyDepartment of Primary Care Health Sciences, University of Oxford Nuffield, Oxford, UK.
Paul AveyardDepartment of Primary Care Health Sciences, University of Oxford Nuffield, Oxford, UK.
Rebecca J BeekenSchool of Medicine, University of Leeds, Leeds, UK.
Angela CraigieSchool of Medicine, University of Dundee, Dundee, UK.
Colin GreavesSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Susan JebbDepartment of Primary Care Health Sciences, University of Oxford Nuffield, Oxford, UK.
Alex McConnachieRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-7262-7000
Kiran NanchahalDepartment of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
Beth StuartWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Martin WhiteMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Simon J GriffinDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Amy L AhernMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Interventions for obesity that require individual behaviour change, such as behavioural weight management interventions, may contribute to health inequalities. We explored if there was evidence of inequalities in the attendance at and effectiveness of behavioural weight management interventions in adults. Design: Two-stage individual participant data meta-analysis. Data sources: Eligible studies were extracted from a previous systematic review and an updated search was completed on PubMed. Eligibility criteria: UK-based randomised controlled trials of behavioural weight management interventions suitable for use in primary care, published until 31 December 2021. Data extraction and synthesis: Multivariable regression analyses were conducted with weight at 12-month follow-up as the primary outcome and included an interaction between inequality characteristic and trial arm (control or intervention). Each model was adjusted for baseline weight, age and gender. Estimated interactions were combined across trials using a random-effects meta-analysis. Intervention attendance was defined as number of in-person sessions attended. Risk of bias was assessed using Cochrane's RoB 2 tool. Results: Data from 13/16 eligible weight loss trials were analysed (complete case data n=5531 participants). The effect of the intervention on weight at 12 months was greater in male participants (-2.58 kg (95% CI -3.52 to 1.64)) than female participants (-1.71 kg (95% CI -2.79 to -0.63); p value for interaction=0.02, tau Conclusions: Behavioural weight management interventions had smaller effects in people from ethnic minority backgrounds and larger effects in men. There was no evidence of other differences in intervention effectiveness or adherence. This is the first synthesis study to access individual participant data and quantitatively assess inequalities in these interventions. Future research should further explore reasons for differences in outcomes and consider how to prevent behavioural weight management interventions from potentially exacerbating health inequalities.

Indexed as

Body Mass IndexPreventive MedicinePublic Health

Identifiers

PMID40791268
PMCPMC12336588

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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.