--- title: "Beh lifestyle interventions for mod & severe obesity: review | Sutter Health" description: "Comprehensive and intensive behavioral interventions can result in clinically significant, albeit modest, weight loss in this obese subpopulation." url: "https://www.sutterhealth.org/research/publications/beh-lifestyle-interventions-mod-severe-obesity-1055312350" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Beh lifestyle interventions for mod & severe obesity: review # Behavioral lifestyle interventions for moderate and severe obesity: a systematic review. Lv N, Azar KMJ, Rosas LG, Wulfovich S, Xiao L, & Ma J. _Prev Med. pii: S0091-7435(17)30142-1. doi: 10.1016/j.ypmed.2017.04.022. \[Epub ahead of print\]_ 2017-04-24 ## Abstract Moderate and severe obesity (BMI ≥35 kg/m2) affect 15% of US adults, with a projected increase over the next two decades. This study reviews evidence of behavioral lifestyle interventions for weight loss in this population. We searched PubMed, PsychInfo, CINAHL®, and Scopus through February 2016 for experimental and quasi-experimental studies that tested a dietary and/or physical activity intervention with a behavioral modification component versus a comparator; and had ≥six-month follow-up and a weight-related primary outcome. Twelve studies representing 1862 participants (mean BMI 37.5-48.3, mean age 30-54 years) were included. Nine studies compared different behavioral interventions and three tested behavioral intervention(s) versus pharmacological or surgical treatments. Among the 25 behavioral interventions in the 12 studies, 18 reported percent of participants achieving clinically significant weight loss up to 12months (32-97% achieving 5% or 3-70% achieving 10%). Three studies measured other cardiometabolic risk factors, but showed no significant risk reduction. Seven interventions with greater effectiveness (i.e., at least 31% achieving ≥10% or 62% achieving ≥5% weight loss up to one year) included multiple components (diet, physical activity, and behavioral strategies), long duration (e.g., one year), and/or intensive contacts (e.g., inpatient stays for clinic-based interventions, weekly contacts for community-based ones). Evidence for the effectiveness of behavioral interventions versus pharmacological or surgical treatment was limited. Comprehensive and intensive behavioral interventions can result in clinically significant, albeit modest, weight loss in this obese subpopulation but may not result significant improvements in other cardiometabolic risk factors. More research on scalable and sustainable interventions is needed. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/28450123) ![Kristen M J Azar, RN, MSN, MPH](https://dyn.mktgcdn.com/p/rFmyR1kiX8JzE5-XNwup0gVC1GRaVTlH7oSDlG0Tr5A/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Kristen M J Azar, RN, MSN, MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985) ## Research topics - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Comparative Effectiveness](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Comparative+Effectiveness%5C%22%22) - [Diabetes, Insulin Resistance and Metabolic Syndrome](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Diabetes%2C+Insulin+Resistance+and+Metabolic+Syndrome%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Food and Nutrition](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Food+and+Nutrition%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [HOMBRE: A randomized controlled trial to compare two approaches to weight loss for overweight and obese Latino men (men with choices to improve well-being and decrease chronic disease risk).](https://www.sutterhealth.org/research/publications/hombre-rct-weight-loss-approaches-latino-men-1055312293) Rosas LG, Lv N, Azar KMJ, Xiao L, Hooker SP, Lewis MA, Zavella P, Venditti EM, Ma J. Contemp Clin Trials. pii: S1551-7144(17)30629-8. doi: 10.1016/j.cct.2018.02.019. \[Epub ahead of print\] 2018 Mar 02 - Publication ### [Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial.](https://www.sutterhealth.org/research/publications/eval-outpt-diabetes-prev-prog-latino-adults-1055312475) Rosas LG, Lv N, Xiao L, Lewis M, Zavella P, Kramer MK, Luna V, Ma J. Contemp Clin Trials. pii: S1551-7144(16)30029-5. doi: 10.1016/j.cct.2016.03.003. \[Epub ahead of print\] 2016 Mar 16 - Publication ### [A Latino Patient-Centered, Evidence-Based Approach to Diabetes Prevention.](https://www.sutterhealth.org/research/publications/latino-pt-centered-evidence-based-approach-to-dm-prevention-1055312326) Rosas LG, Lv N, Lewis MA, Venditti EM, Zavella P, Luna V, Ma J. J Am Board Fam Med. 31(3):364-374. doi: 10.3122/jabfm.2018.03.170280. 2018 May 01 - Publication ### [The Electronic CardioMetabolic Program (eCMP) for patients with cardiometabolic risk: a randomized controlled trial.](https://www.sutterhealth.org/research/publications/electronic-cardiometabolic-program-1055312305) Azar KM, Koliwad S, Poon T, Xiao L, Lv N, Griggs R, Ma J. J Med Internet Res. 18(5):e134. doi: 10.2196/jmir.5143. 2016 May 27 - Publication ### [Precision lifestyle medicine: a new frontier in the science of behavior change and population health.](https://www.sutterhealth.org/research/publications/precision-lifestyle-medicine-1055312346) Ma J, Rosas LG, Lv N. Am J Prev Med. pii: S0749-3797(15)00638-8. doi: 10.1016/j.amepre.2015.09.035. \[Epub ahead of print\] 2015 Dec 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/beh-lifestyle-interventions-mod-severe-obesity-1055312350#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Beh lifestyle interventions for mod & severe obesity: review"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/beh-lifestyle-interventions-mod-severe-obesity-1055312350#medicalscholarlyarticle","name":"Behavioral lifestyle interventions for moderate and severe obesity: a systematic review.","headline":"Beh lifestyle interventions for mod & severe obesity: review","abstract":"Moderate and severe obesity (BMI ≥35 kg/m2) affect 15% of US adults, with a projected increase over the next two decades. This study reviews evidence of behavioral lifestyle interventions for weight loss in this population. We searched PubMed, PsychInfo, CINAHL®, and Scopus through February 2016 for experimental and quasi-experimental studies that tested a dietary and/or physical activity intervention with a behavioral modification component versus a comparator; and had ≥six-month follow-up and a weight-related primary outcome. Twelve studies representing 1862 participants (mean BMI 37.5-48.3, mean age 30-54 years) were included. Nine studies compared different behavioral interventions and three tested behavioral intervention(s) versus pharmacological or surgical treatments. Among the 25 behavioral interventions in the 12 studies, 18 reported percent of participants achieving clinically significant weight loss up to 12months (32-97% achieving 5% or 3-70% achieving 10%). Three studies measured other cardiometabolic risk factors, but showed no significant risk reduction. Seven interventions with greater effectiveness (i.e., at least 31% achieving ≥10% or 62% achieving ≥5% weight loss up to one year) included multiple components (diet, physical activity, and behavioral strategies), long duration (e.g., one year), and/or intensive contacts (e.g., inpatient stays for clinic-based interventions, weekly contacts for community-based ones). Evidence for the effectiveness of behavioral interventions versus pharmacological or surgical treatment was limited. Comprehensive and intensive behavioral interventions can result in clinically significant, albeit modest, weight loss in this obese subpopulation but may not result significant improvements in other cardiometabolic risk factors. 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