Adherence
Standard long-term weight management RCTs for severe obesity (BMI ≥35 kg/m2) systematically exclude or underrepresent underserved groups (low SES, racial minorities, mental health conditions), rendering the evidence base non-generalizable to the populations most at risk of severe obesity.
Current weight management guidelines for severe obesity are largely based on research that excludes the people who need them most (those with lower income, mental health issues, or minority backgrounds). If you belong to an underserved group, standard advice may not work for you because it wasn't tested on people like you. Seek programs that explicitly adapt to your cultural, socioeconomic, and logistical needs, rather than assuming standard protocols will be effective.
Our findings demonstrate that most trialists testing weight management strategies to help adults with severe obesity fail to consider populations who are most at risk of poorer health outcomes.
Why this rating
Based on a systematic review of 131 RCTs, though limited by poor reporting in primary studies.
Source
Does weight management research for adults with severe obesity represent them? Analysis of systematic review data
Clare Robertson et al. · BMJ Open · 2022
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