Is a small change approach for weight management effective? A systematic review and meta?analysis of randomized controlled trials

Graham, Henrietta Emily, Madigan, Claire Deborah and Daley, Amanda Jane 2022. Is a small change approach for weight management effective? A systematic review and meta?analysis of randomized controlled trials. Obesity Reviews 23 (2) , e13357. 10.1111/obr.13357

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Abstract

Traditional weight management interventions typically involve people making large changes to their energy intake and/or expenditure and can be effective in the short term, but weight regain is common. An alternative strategy is a small change approach, which asks people to make small(er) changes to their diet and/or physical activity behaviors (e.g., 100-kcal reduction or increases of 1000 steps/day). This approach may lead to sustained weight management because such energy-deficit goals are easier for people to integrate into their lives and then maintain. This systematic review and meta-analysis of randomized and quasi-randomized controlled trials assessed the effectiveness of a small change approach for weight management; 21 trials were included. In weight gain prevention trials with adults, the mean difference in weight change between groups was −0.7 kg (95% CI −1.0 to −0.4, 95% PI −1.1 to −0.3) at program-end and −0.9 kg (95% CI −1.5 to −0.3, 95% PI −3.1 to 1.3) at last follow-up, favoring small change interventions. A small change approach was not effective for weight loss. Only 2/21 trials had a low risk of bias. Initial evidence supports the effectiveness of a small change approach for weight gain prevention but not weight loss. Further high-quality trials with longer follow-up are required.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Professional Services > Academic & Student Support Service
Publisher:	Wiley
ISSN:	1467-7881
Funders:	NIHR, Department of Health and Social Care, UK
Date of Acceptance:	16 August 2021
Last Modified:	03 Dec 2025 10:30
URI:	https://orca.cardiff.ac.uk/id/eprint/182832

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