Weight regain after cessation of medication for weight management: systematic review and meta-analysis.

Methods

Systematic reviewand meta-analysis.

系统评价和荟萃分析。

study_selection

Trial registries and databases (Medline, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries) were searched from inception until February 2025 for randomised controlled trials (RCTs), non-randomised trials, and observational studies that included WMM (≥8 weeks) with follow-up for ≥4 weeks after cessation of treatment in adults with overweight or obesity.

从数据库建立之初至2025年2月，通过检索试验注册处和数据库（Medline、Embase、PsycINFO、CINAHL、Cochrane、Web of Science以及试验注册处）寻找随机对照试验（RCTs）、非随机试验和观察性研究，这些研究包括了体重管理计划（WMM，持续时间≥8周），并在治疗停止后至少有4周的随访，研究对象为超重或肥胖的成年人。

Comparators were any non-drug weight loss intervention or placebo.

比较对象为任何非药物性减重干预措施或安慰剂。

data_extraction_and_synthesis

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

本综述遵循了系统评价和荟萃分析报告的首选条目（PRISMA）指南。

Two independent reviewers screened titles, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool for RCTs and the ROBINS-I tool for non-randomised trials.

两位独立的评审员筛选标题，提取数据，并使用Cochrane偏倚风险评估工具第2版（针对随机对照试验）和ROBINS-I工具（针对非随机试验）评估偏倚风险。

Data were analysed using mixed effect, meta-regression, and time-to-event models.

数据分析采用了混合效应、元回归和时间事件模型。

Weight regain after cessation of WMM was compared with that reported after cessation of behavioural weight management programmes (BWMPs).

停止WMM后的体重反弹与停止行为性体重管理计划（BWMPs）后报告的体重反弹进行了比较。

Methods

The primary outcome was rate of weight regain from end of treatment, with associated changes in cardiometabolic markers as a secondary outcome.

主要结果是治疗结束后的体重恢复率，伴随的心血管代谢标志物变化作为次要结果。

Results

Of the 9288 titles screened, 37 studies (63 intervention arms, 9341 participants) were included.

在筛选的9288个标题中，包括了37项研究（63个干预组，9341名参与者）。

Average treatment duration was 39 (range 11-176) weeks, with average follow-up of 32 (4-104) weeks.

平均治疗持续时间为39周（范围11-176周），平均随访时间为32周（4-104周）。

The average monthly rate of weight regain was 0.4 kg (95% confidence interval(CI) 0.3 to 0.5) (mixed model 0.3 kg (0.2 to 0.4) monthly v control in RCTs).

平均每月体重恢复速度为0.4公斤（95%置信区间（CI）0.3至0.5）（混合模型中，每月0.3公斤（0.2至0.4）与随机对照试验中的对照组相比）。

All cardiometabolic markers were projected to return to baseline within 1.4 years after the cessation of WMM.

所有心代谢标志物预计在停用WMM后1.4年内恢复至基线水平。

Weight regain was faster after WMM than after BWMP (by 0.3 kg (0.22 to 0.34) monthly), independent of initial weight loss.

停用WMM后的体重恢复速度比停用BWMP快（每月快0.3公斤（0.22到0.34）），且与初始减重无关。

Estimates and precision were robust in sensitivity analyses.

在敏感性分析中，估计值和精确度均显示出稳健性。

Conclusions

This review found that cessation of WMM is followed by rapid weight regain and reversal of beneficial effects on cardiometabolic markers.

本综述发现，停止体重管理计划（WMM）后，体重迅速反弹，并且对心脏代谢标志物的有益效果逆转。

Regain after WMM was faster than after BWMP.

在WMM之后的体重恢复速度比在BWMP之后更快。

These findings suggest caution in short term use of these drugs without a more comprehensive approach to weight management.

这些发现表明，在没有更全面的体重管理方法的情况下，应谨慎短期使用这些药物。

systematic_review_registration

PROSPERO CRD42024532069.

PROSPERO CRD42024532069。