Review: non-pharmacological interventions induce or maintain weight loss in adults with prediabetes

摘要

The review by Norris ef al provides evidence that non-pharmacological interventions for adults with impaired glucose tolerance are effective in producing long term weight loss and modest, but clinically meaningful, improvement in metabolic outcomes.A strength of the review is that the original RCTs included participants from the US (including ethnic minorities), UK, Europe, and Asia, and so the findings may be generalisable to diverse populations. The results support the clinical guidelines for the treatment of overweight and obesity published by the National Heart, Lung, and Blood Institute, and World Health Organization.These 2 organisations recommend combined interventions of caloric restriction, increased physical activity, and behaviour therapy.Weight loss interventions were most often implemented by dietitians or exercise physiologists, a feature that must be addressed in the context of dissemination and translation to clinical practice. Implications of this review go beyond clinical translation to that of policy and suggest that resources (dietitians and exercise physiologists) and reimbursement issues should be addressed in an effort to make effective weight loss interventions available to all people needing such intervention.