Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis

Abstract

Introduction In recent years, overweight and obesity have reached an alarmingly high incidence and prevalence worldwide; they have also been steadily increasing in military populations. Military personnel as an occupational group are often exposed to stressful and harmful environments that represent a risk factor for disordered eating with major repercussions on both physical and mental health. Objectives This study aims to explore the effectiveness of weight loss interventions and to assess the significance of current obesity treatments for military populations. Methods Three online databases (PubMed, PsycInfo, and Web of Science) were screened to identify randomized controlled trials (RCTs) aiming to treat obesity in active-duty military personnel and veterans. Random-effects meta-analyses were conducted for body weight (BW) and body mass index (BMI) values, both longitudinally comparing treatment group from pre-to-post intervention, and cross-sectionally comparing the treatment group to controls at the end of the intervention. Results A total of 21 studies were included: 16 cross-sectional (BW: n=15; BMI: n=12) and 16 longitudinal (BW: n=15; BMI: n=12) were meta-analyzed, and 5 studies were narratively synthesized. A significant small overall BW and BMI reduction from baseline to post-intervention was observed (BW: g = -0.10; p = 0.015; BMI: g = -0.32; p < 0.001), together with a decreased BMI ( g = -0.16; p = 0.001) and nominally lower BW ( g = -0.08; p = 0.178) in the intervention group compared to controls at post-intervention time-point. When conducting additional meta-analyses dividing by sample type, a significant decrease in both BMI (g= -0.35; p< 0.001) and BW (g= -0.12; p= 0.041) from pre-to-post intervention was observed in active-duty military personnel but not for veterans.Recommendations for clinical practice have been outlined from the findings of this study and summarized in Figure 1. Image: Conclusions Despite limitations, such as the heterogeneity across the included interventions and the follow-up duration, our findings highlight how current weight loss interventions are effective in term of BW and BMI reductions in military populations, and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention. Disclosure of Interest None Declared