Summary characteristics and outcomes of weight management interventions (further details are presented in online supplementary files 2–8
BMI (kg/m2) | WC (cm) | WT (kg) | |||||||||||
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Study ID | Study characteristics | N | Description | Mean change from baseline§ | SD/95% CI | Mean change from baseline§ | SD | Mean change from baseline§ | SD/95% CI | Global quality rating* | Effectiveness† | Cost-effectiveness | Differential effects‡ |
Ahrens et al41 2011 | Design: RCT Duration: 22 weeks¶ Country: USA Number of pharmacies: 1 Number of participants: 95 Mean age: I: 47.6; C: 47.8 % female: 87 Baseline BMI: I: 29.5; C: 29.0 | 45 | Meal replacement diet | NR | NR | −8.08 | NR | −5.6 | NR | Weak | ↔ | NR | NR |
43 | Low calorie diet | NR | NR | −7.82 | NR | −5.2 | NR | ||||||
Bush et al42 | Design: CBA Duration: 15 weeks¶ Country: UK Number of pharmacies: 12 Number of participants: 451 Mean age: I: 38.9; C: 42.6 % female: I: 87; C: 85 Baseline BMI: I: 33.0; C: 35.6 | 60 | Pharmacy-based diet + physical activity | −1.3 | 0.4 | −6.5 | 1.6 | −3.4 | 1.1 | Weak | ? | Unclear which service was more cost effective | Yes, demographics of participants differed significantly between settings |
22 | GP-based diet + physical activity | −0.8 | 0.7 | −4.9 | 2.6 | −2.3 | 1.9 | ||||||
Jolly et al43** | Design: RCT Duration: 52 weeks¶ Country: UK Number of pharmacies:NR Number of participants: 740 Mean age: Ph: 48.9; Ex: 49.7; WW: 50.7; SW: 48.8;RC: 48.8; NHS SD: 48.8; GP: 50.5; POC: 47.5 % female: Ph: 73; Ex: 75; WW: 72; SW: 65; RC: 69; NHS SD: 64; GP: 67; POC: 70 Baseline BMI: P: 33.4; Ex: 33.9; WW: 34.0; SW: 33.8; RC: 33.4; NHS SD: 33.8; GP: 33.1; POC: 33.4 | 70 | Pharmacy-based diet + physical activity | −0.31 | −0.7 to 0.0 | NR | NR | −0.66 | −1.7 to 0.4 | Moderate | ↔ | Cost analysis only, commercial organisations lower cost than GP and pharmacy-based services | No (gender) |
100 | Exercise only control | −0.45 | −0.8 to −0.1 | NR | NR | −1.08 | −2.1 to −0.1 | ‡ | |||||
100 | Weight Watchers | −1.17 | −1.7 to −0.7 | NR | NR | −3.46 | −4.8 to −2.1 | ↑ | |||||
100 | Slimming World | −0.71 | −1.0 to −0.4 | NR | NR | −1.89 | −2.9 to −0.9 | ↔ | |||||
100 | Rosemary Conley | −0.75 | −1.1 to −0.3 | NR | NR | −2.12 | −3.4 to −0.9 | ↔ | |||||
100 | NHS Size Down | −0.67 | −1.0 to −0.3 | NR | NR | −2.45 | −3.6 to −1.3 | ↔ | |||||
70 | GP | −0.32 | −0.7 to 0.1 | NR | NR | −0.83 | −2.0 to 0.4 | ↔ | |||||
100 | Participants own choice | −0.90 | −1.3 to −0.5 | NR | NR | −2.15 | −3.4 to −0.9 | ↔ | |||||
Malone and Alger-Mayer44 | Design: nRCT Duration: 26 weeks¶ Country: USA Number of pharmacies: NR Number of participants: 30 Mean age: I: 44.9; C: 42.8 % female: I: 93; C: 80 Baseline BMI: I: 48.3; C: 42.8 | 15 | Pharmacist support + orlistat + usual outpatient care | NR | NR | NR | NR | −3.5 | 2.9 | Weak | ↔ | NR | NR |
15 | orlistat + usual outpatient care | NR | NR | NR | NR | −3.0 | 5.2 | ||||||
Phimarn et al45 | Design: RCT Duration: 16 weeks¶ Country: Thailand Number of pharmac ies: 1 Number of participants: 66 Mean age: I: 60.1; C: 59.1 % female: I: 75.8; C: 84.8 Baseline BMI: I: 27.5; C: 27.7 | 33 | Pharmacist individual support | −0.8 | 0.07 | 0.1 | 0.03 | −0.82 | 0.29 | Strong | ↔ | NR | NR |
33 | Primary care unit group support | 0.19 | 0.04 | −0.28 | 0.08 | 0.92 | 0.19 |
*Global rating: ‘strong’=no ‘weak’ ratings, ‘moderate’=one ‘weak’ rating and ‘weak’=two or more ‘weak’ ratings.
†Effectiveness was assessed using between group differences.
‡Differential effects: age, gender, ethnicity or socioeconomic status (education, income, occupation, social class, deprivation or poverty).
**All intervention groups in the Jolly trial were compared to the exercise only control group (intervention groups were not directly compared).
§p Values were extracted directly from the study papers and relate to between group differences.
¶From baseline to last follow-up.
↓, intervention not effective; ↑, intervention effective; ↔, no statistically significant between group difference; ?, unable to assess effectiveness/cost-effectiveness; BMI, body mass index; C, control group; CBA, controlled before-after study; Ex, exercise only control; GP, general practitioner; NHS SD, NHS Size Down; NHS, National Health Service; NR, not reported; nRCT, non-randomised controlled trial; NS, non-significant; Ph, Pharmacy-based diet + physical activity; POC, participants own choice; RC, Rosemary Conley; RCT, randomised controlled trial; SW, Slimming World; WC, waist circumference; WT, weight; WW, Weight Watchers.