Authors' objectives: Behavioural weight management interventions are the primary treatment for obesity in the United Kingdom. These interventions focus on diet, physical activity and behaviour change, and are typically delivered over a period of 12 weeks. Although National Institute for Health and Care Excellence guidance makes recommendations on the content of behavioural weight management interventions, there are substantial variations in practice. As a result, what constitutes the most effective composition of behavioural weight management interventions is unclear. To determine the effectiveness of different types of behavioural weight management interventions in achieving weight loss, using individual participant data from randomised controlled trials and real-world services.

Authors' results and conclusions: All behavioural weight management interventions resulted in weight loss compared to usual care. In the randomised controlled trials, the 52-week weightloss programme referrals for adults in primary care (WRAP) with participants attending intervention achieved the greatest weight reduction at 12 weeks (mean difference = −2.58 kg, 95% credible interval −3.19 to −1.96). However, when a male-only intervention (football fans in training) was included in a sensitivity analysis, it demonstrated the largest short-term weight loss (mean difference = −4.65 kg, credible interval −5.24 to −4.07). In the real-world services, several programmes achieved substantial weight loss, with greater programme attendance associated with improved outcomes. The behavioural weight management intervention in both real-world services and randomised controlled trials are effective for weight loss, but there is a variation in the weight loss achieved at the end of active weight loss period depending upon the structure of intervention and participant engagement.

Authors' methods: A network meta-analysis of individual participant data. Behavioural weight management interventions delivered in the community. Anonymous individual participant data of adults (> 18 years), living in the United Kingdom and attending behavioural weight management interventions in the real world (n = 76,201) and randomised controlled trial’s (n = 4051). Two-staged Bayesian network meta-analysis of individual participant data from included randomised controlled trials and real-world services was performed. Risk of bias was assessed for randomised controlled trials using Cochrane Risk of Bias 2.0. Prior to analysis, received data were checked, for consistency with the requests and cleaned for all anomalies.

Project Status: Completed

URL for project: https://www.journalslibrary.nihr.ac.uk/programmes/hta/NIHR135917

Year Published: 2025

URL for published report: https://www.journalslibrary.nihr.ac.uk/hta/published-articles/GJJL0404

URL for additional information: English

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: England, United Kingdom

DOI: 10.3310/GJJL0404

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk