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Introduction <p>Adult weight management interventions are complex; better understanding of the intervention components that may impact eating disorder (ED) risk is required.</p> Methods <p>Weight management randomized controlled trials (RCTs) for adults with overweight/obesity that measured ED risk were systematically searched in four databases and two trial registries. A project-specific codebook was used to code 84 delivery features and 89 intervention strategies of trials. Individual strategies were grouped into 20 clusters which were further grouped into five broad categories. Trial investigators verified coding and narrative synthesis using descriptive statistics of findings was reported.</p> Results <p>Of 14,880 identified, 58 eligible trials were coded, of which 26 trials with 64 intervention arms were verified and therefore included. Intervention arms included a mean (SD) of 24 (11) intervention strategies. Commonly used intervention strategy clusters were nutrition education (91%), dietary behavior change strategies (84%), physical activity education (81%), and dietary self-monitoring (80%). Few interventions used strategies in the category of psychological components (13–41%). The median (range) intervention duration was 27 (4–104) weeks, and contacts with participants typically included a staged approach of weekly to monthly contact.</p> Conclusion <p>Adult weight management interventions are multifactorial with varying delivery features and intervention strategies. Despite this, psychological (e.g. weight stigma) and sleep-health related strategies are either rarely used or are underreported. Breaking down intervention components using our framework can help identify which strategies influence outcomes, including eating disorder risk, and inform the design and reporting of future interventions.</p> Plain English summary <p>Some adults seeking weight management for obesity may have an eating disorder or disordered eating behaviors. Research shows most people who take part in behavioral weight management programs have an improvement in eating disorder symptoms, however a small number may experience worsening symptoms. In this study, we break down behavioral weight management programs that measure eating disorder risk to better understand the features they use. We found that these programs vary widely in the number and type of strategies they use, as well as in how they are delivered, such as the length of the program. Strategies that focus on psychological factors (for example, addressing weight stigma) and sleep health were rarely used or reported. These findings are useful in guiding the design and reporting of future behavioral weight management programs. They can also be used in future research to determine which specific program features improve or worsen outcomes such as eating disorder risk.</p>

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Unpacking weight management interventions measuring eating disorder risk in adults: coding of components of interventions in a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月17日

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  • Natalie B. Lister,
  • Rabia Khalid,
  • Isabelle R. Jardine,
  • Samantha Pryde,
  • Hannah Melville,
  • Anna L. Seidler,
  • Kylie E. Hunter,
  • Amy L. Ahern,
  • Louise A. Baur,
  • Caroline Braet,
  • Sarah P. Garnett,
  • Andrew J. Hill,
  • Sarah Maguire,
  • Dasha Nicholls,
  • Susan J. Paxton,
  • Milan K. Piya,
  • Amanda Sainsbury,
  • Katharine Steinbeck,
  • Denise E. Wilfley,
  • Kelly Cooper,
  • Genevieve Dammery,
  • Alicia M. Grunseit,
  • Faith Anne N. Heeren,
  • Rebecca A. Jones,
  • Theodore K. Kyle,
  • Fiona Quigley,
  • Molly Robbins,
  • Aviva H. Ariel-Donges,
  • Rachel D. Barnes,
  • Kristine Beaulieu,
  • Kerri N. Boutelle,
  • Simona Calugi,
  • Kelly M. Carpenter,
  • Hoi Lun Cheng,
  • Riccardo Dalle Grave,
  • Marcelo Demarzo,
  • Dawn M. Eichen,
  • Erin L. Glynn,
  • Katrijn Houben,
  • Corby K. Martin,
  • Janell L. Mensinger,
  • Jayanthi Raman,
  • Kristin M. von Ranson,
  • Hollie A. Raynor,
  • Elizabeth Rieger,
  • Eric Robinson,
  • Vera Salvo,
  • Nancy E. Sherwood,
  • Sharon A. Simpson,
  • Evelyn Smith,
  • Rachael W. Taylor,
  • Krista A. Varady,
  • Victoria Whitelock,
  • Brittany J. Johnson,
  • Hiba Jebeile

摘要

Introduction

Adult weight management interventions are complex; better understanding of the intervention components that may impact eating disorder (ED) risk is required.

Methods

Weight management randomized controlled trials (RCTs) for adults with overweight/obesity that measured ED risk were systematically searched in four databases and two trial registries. A project-specific codebook was used to code 84 delivery features and 89 intervention strategies of trials. Individual strategies were grouped into 20 clusters which were further grouped into five broad categories. Trial investigators verified coding and narrative synthesis using descriptive statistics of findings was reported.

Results

Of 14,880 identified, 58 eligible trials were coded, of which 26 trials with 64 intervention arms were verified and therefore included. Intervention arms included a mean (SD) of 24 (11) intervention strategies. Commonly used intervention strategy clusters were nutrition education (91%), dietary behavior change strategies (84%), physical activity education (81%), and dietary self-monitoring (80%). Few interventions used strategies in the category of psychological components (13–41%). The median (range) intervention duration was 27 (4–104) weeks, and contacts with participants typically included a staged approach of weekly to monthly contact.

Conclusion

Adult weight management interventions are multifactorial with varying delivery features and intervention strategies. Despite this, psychological (e.g. weight stigma) and sleep-health related strategies are either rarely used or are underreported. Breaking down intervention components using our framework can help identify which strategies influence outcomes, including eating disorder risk, and inform the design and reporting of future interventions.

Plain English summary

Some adults seeking weight management for obesity may have an eating disorder or disordered eating behaviors. Research shows most people who take part in behavioral weight management programs have an improvement in eating disorder symptoms, however a small number may experience worsening symptoms. In this study, we break down behavioral weight management programs that measure eating disorder risk to better understand the features they use. We found that these programs vary widely in the number and type of strategies they use, as well as in how they are delivered, such as the length of the program. Strategies that focus on psychological factors (for example, addressing weight stigma) and sleep health were rarely used or reported. These findings are useful in guiding the design and reporting of future behavioral weight management programs. They can also be used in future research to determine which specific program features improve or worsen outcomes such as eating disorder risk.