Adherence
Behavioral weight management interventions (WLs and WLMs) generally do not exacerbate health inequalities, as most trials find no significant gradient in uptake, adherence, or outcomes across socioeconomic and demographic groups.
Most behavioral weight loss programs work similarly across different social groups. If you are from a disadvantaged background, do not assume the program will fail you; most evidence shows no difference in outcome compared to advantaged groups. However, if you do struggle with adherence, it may be because the program requires high personal agency (time/education) which might be a barrier for you.
Most trials found no inequalities gradient. If a gradient was observed for trial uptake, intervention adherence, and trial attrition, those considered 'more advantaged' did best.
Why this rating
Based on a systematic review of 103 RCTs, though narrative synthesis limits statistical power.
Source
A systematic review of inequalities in the uptake of, adherence to, and effectiveness of behavioral weight management interventions in adults
Jack M Birch et al. · Obesity Reviews · 2022
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