Title:Long-term Lifestyle-modification Programs for Overweight and Obesity Management in the Arab States: Systematic Review and Meta-analysis
VOLUME: 14 ISSUE: 6
Author(s):Dima Kreidieh, Leila Itani, Germine El Kassas, Dana El Masri, Simona Calugi, Riccardo Dalle Grave and Marwan El Ghoch*
Affiliation:Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda (VR), Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda (VR), Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut
Keywords:Obesity, overweight, type 2 diabetes, lifestyle modification, weight loss treatment, Arab countries.
Abstract:Background: Obesity is a growing health problem worldwide. It is associated with serious
medical and psychosocial comorbidities that increase the risk of mortality. However, strong evidence
confirms lifestyle-modification programs as the cornerstone treatment for excess weight and obesity.
The aim of this systematic review was to assess the effectiveness of the lifestyle-modification programs
for weight management delivered in Arabic-speaking countries.
Methods: The PubMed database was searched, and studies conducted in humans were identified and
screened as per the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA)
guidelines. Data were collated using meta-analysis and a narrative approach.
Results: Of the 1057 articles retrieved, six studies, conducted in four Arab countries, comprising a total
of 444 adolescent and adult participants of both genders with overweight and obesity, met the inclusion
criteria and were reviewed. Most studies that assessed weight loss at 6-month follow-up showed
no significant reduction in body weight. Meta-analysis confirmed that the lifestyle-modification programs
delivered were no more effective than other treatments. Only one article reported significant
weight-loss maintenance after 12 months of follow-up. However this was a prospective non-controlled
study in which the weight loss maintained (=4%) did not conform to the standard for clinical significance
(>10%).
Conclusion: Lifestyle-modification programs for weight management delivered in Arabic-speaking
countries seem lacking in effectiveness due to methodological weaknesses in program adaptation, a
lack of expert clinical supervision before and during implementation, and the presence of barriers to
lifestyle modification, especially for women. Future studies should bear these features in mind.
