Weight loss following lifestyle modification interventions among adults with overweight and obesity in low- and middle-income countries – A systematic review and meta-analysis protocol

Abstract

Introduction: Overweight and obesity have become complex public health issues affecting all age, gender, and socioeconomic groups. It is a significant risk factor for various noncommunicable diseases such as hypertension, liver and kidney disease, diabetes, cardiovascular diseases, and depression. Despite this, obesity screening, prevention, and treatment are insufficiently focused in the health systems in low- and middle-income countries. There is a need for targeted interventions that are more realistic, applicable to all population groups, and have the potential for higher success rates. With this idea in mind, the current review has focused on systematically gathering evidence on the effect of weight management interventions compared to the standard of care among adults with overweight and obesity from low- and middle-income countries. Methodology: We will systematically search four electronic databases – PubMed, Google Scholar, Embase, and the Cochrane Library from their inception until July 2023 for relevant studies. A combination of medical subject headings and free text terms will be used for carrying out literature searches. All the experimental studies randomized controlled trials or nonrandomized trials conducted in a clinic-, hospital-, or community-based setting will be included in our review. Studies conducted among adults aged 18 years and above with overweight or obesity with nonpharmacological weight management given as intervention and standard of care given as comparator will be looked for. The outcome measures include the standardized mean difference of weight, body mass index, waist or hip circumference, or odds ratio of obesity or overweight between the treatment groups. Meta-regression or subgroup analyses will be performed to explore the heterogeneity. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines will be used to report the review. Study Design: Systematic review and meta-analysis. Ethics and Dissemination: There are no ethical concerns about the conduct of this review. Evidence will be disseminated at relevant conferences and by submitting scientific articles to academic peer-reviewed journals. Conclusion: Findings from this systematic review will significantly contribute to enhancing knowledge about evidence of the effectiveness of various obesity management strategies. This evidence-based approach will guide informed decision-making processes and support the development of effective interventions or programs to address the obesity epidemic in low- and middle-income countries. Prospero Registration: CRD42022352118.

Keywords

• noncommunicable diseases
• nutrition
• obesity
• physical activity
• weight loss