TY - JOUR
T1 - Randomized Controlled Trials to Treat Obesity in Military Populations
T2 - A Systematic Review and Meta-Analysis
AU - Gravina, Davide
AU - Keeler, Johanna Louise
AU - Akkese, Melahat Nur
AU - Bektas, Sevgi
AU - Fina, Paula
AU - Tweed, Charles
AU - Willmund, Gerd Dieter
AU - Treasure, Janet
AU - Himmerich, Hubertus
N1 - Funding Information:
J.L.K. acknowledges financial support from a Medical Research Council (MRC)-funded Doctoral Training Partnership stipend (ref: MR/N013700/1). M.N.A. and S.B. acknowledge financial support from the Turkish Ministry of National Education for granting an official scholarship for her PhD education at King’s College London University. The funder had no role in this project. J.T. has received salary support from the NIHR BRC at the South London and Maudsley NHS Foundation Trust (SLaM) and KCL. H.H. has received salary support from the NIHR BRC at the South London and Maudsley NHS Foundation Trust (SLaM) and KCL.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/11
Y1 - 2023/11
N2 - 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. This study aims to explore the effectiveness of weight loss interventions and assess the significance of current obesity treatments for these populations. 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 groups from pre-to-post intervention and cross-sectionally comparing the treatment group to controls at the end of the intervention. 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) studies 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 the post-intervention time-point. 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 terms of BW and BMI reductions in military populations and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention.
AB - 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. This study aims to explore the effectiveness of weight loss interventions and assess the significance of current obesity treatments for these populations. 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 groups from pre-to-post intervention and cross-sectionally comparing the treatment group to controls at the end of the intervention. 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) studies 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 the post-intervention time-point. 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 terms of BW and BMI reductions in military populations and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention.
KW - active-duty military personnel
KW - meta-analysis
KW - military population
KW - obesity
KW - obesity treatment
KW - randomized controlled trial
KW - RCT
KW - veterans
KW - weight loss intervention
UR - http://www.scopus.com/inward/record.url?scp=85177791928&partnerID=8YFLogxK
U2 - 10.3390/nu15224778
DO - 10.3390/nu15224778
M3 - Review article
C2 - 38004172
AN - SCOPUS:85177791928
SN - 2072-6643
VL - 15
JO - Nutrients
JF - Nutrients
IS - 22
M1 - 4778
ER -
