Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis

Abstract Background Postpartum depression (PPD) is a prevalent complication of pregnancy, this condition affects maternal and child well-being and functioning. Results from a meta-analysis showed an incidence of 13% PPD cases in the first 12 weeks after labor. Primary care is the first gate and continuing point of care for patients. Despite the controversy of screening and early identification in primary care settings, many PPD cases remain undetected. Given the uncertainty about this issue, screening instruments must be effective in identifying the cases. This systematic review and meta-analyses aim to identify the most suitable postpartum depression screening instrument for use in primary care. Methods PubMed, ScienceDirect, and ProQuest databases were used to search using relevant keywords or MeSH, with limitation of publication from January 1st, 2010 through December 31st, 2020. We will include screening studies on postpartum women using validated screening tools followed by validated structured or semi-structured interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) as the reference standard in the primary care setting. Study designs included in the review are cross-sectional and randomized controlled trial without no screening arm on the diagnostic study. We will use a liberal accelerated method on the title and abstract review stage, then perform full-text article reviews on selected studies. Methodological quality will be assessed independently by two authors according to QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2). Extraction of the study data will be undertaken by one reviewer and checked by a second reviewer. Disagreements will be resolved by consensus and including a third investigator as necessary. The test characteristics will be extracted into 2x2 tables for all included studies. Study-specific estimates of sensitivity and specificity with 95% confidence intervals will be displayed in forest plots. Discussion The proposed systematic review and meta-analyses will allow us to obtain the most suitable postpartum depression screening instrument for use in primary care. Systematic review registration: PROSPERO CRD42020216067

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Effectiveness of a Single Physician-led Weight loss Program in Primary Care Setting

10.22541/au.161976509.98973914/v1 ◽

2021 ◽

Author(s):

Varalakshmi Niranjan ◽

Aleksandra Sliwinska ◽

Fufei Chen ◽

Srinath Ramanan ◽

Narinder Maheshwari ◽

...

Keyword(s):

Primary Care ◽

Weight Loss ◽

Retrospective Analysis ◽

Weight Change ◽

Care Setting ◽

Primary Care Setting ◽

Weight Loss Program ◽

Time Period ◽

Percentage Weight ◽

Weight Loss Interventions

Abstract Objective The aim of this study is to examine the effectiveness of a single physician-led weight loss program in a primary care. Methods This is a retrospective analysis of 300 patients with a BMI >30 kg/m2 in an outpatient weight loss program. Weight loss interventions included lifestyle counseling and pharmacotherapy. Outcomes were assessed based on percentage weight change during a time period of two consecutive visits less than 90 days. Results We found that 57.7%, 43.3% and 16.1% patients who attended the clinic 5 or more times, 4-5 times, 2-3 times respectively achieved 5% weight loss (p < 0.0001). In regard to achieving 10% weight loss, 42.3%, 8.7% and 4.3% patients who attended the clinic 5 or more times, 4-5 times and 2-3 times did it respectively (p<0.0001). Moreover 60% of patients achieved 5% of weight loss in about 200 days, and 40% achieved 10% weight loss in 350 days. Patients who achieved 5% weight loss, their average A1c was reduced to 5.8 at their last visit from 6.4 at the first visit. Conclusions A single physician-led weight loss program is effective and can be created within a primary care setting to achieve 5-10% weight loss.

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Incidence of successful pregnancy after weight loss interventions in infertile women: a systematic review and meta-analysis of the literature

10.26226/morressier.573c1513d462b80296c988c4 ◽

2016 ◽

Author(s):

Loredana Maria Sosa Fernandez

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Meta Analysis ◽

Successful Pregnancy ◽

Infertile Women ◽

Weight Loss Interventions

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European Guidelines for Obesity Management in Adults with a Very Low-Calorie Ketogenic Diet: A Systematic Review and Meta-Analysis

Obesity Facts ◽

10.1159/000515381 ◽

2021 ◽

Vol 14 (2) ◽

pp. 222-245

Author(s):

Giovanna Muscogiuri ◽

Marwan El Ghoch ◽

Annamaria Colao ◽

Maria Hassapidou ◽

Volkan Yumuk ◽

...

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Body Composition ◽

Body Weight ◽

Side Effects ◽

Ketogenic Diet ◽

Meta Analysis ◽

Dietary Treatment ◽

Obesity Management ◽

Weight Loss Interventions

Background: The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low carbohydrate content (<50 g/day), 1–1.5 g of protein/kg of ideal body weight, 15–30 g of fat/day, and a daily intake of about 500–800 calories. Objectives: The aim of the current document is to suggest a common protocol for VLCKD and to summarize the existing literature on its efficacy in weight management and weight-related comorbidities, as well as the possible side effects. Methods: This document has been prepared in adherence with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Literature searches, study selection, methodology development, and quality appraisal were performed independently by 2 authors and the data were collated by means of a meta-analysis and narrative synthesis. Results: Of the 645 articles retrieved, 15 studies met the inclusion criteria and were reviewed, revealing 4 main findings. First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference, total cholesterol and triglyceridemia as well as improved insulin resistance. Third, although the VLCKD also resulted in a significant reduction of glycemia, HbA1c, and LDL cholesterol, these changes were similar to those obtained with other weight loss interventions. Finally, the VLCKD can be considered a safe nutritional approach under a health professional’s supervision since the most common side effects are usually clinically mild and easily to manage and recovery is often spontaneous. Conclusions: The VLCKD can be recommended as an effective dietary treatment for individuals with obesity after considering potential contra-indications and keeping in mind that any dietary treatment has to be personalized. Prospero Registry: The assessment of the efficacy of VLCKD on body weight, body composition, glycemic and lipid parameters in overweight and obese subjects: a meta-analysis (CRD42020205189).

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