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Title: Self-directed interventions to promote weight loss: a systematic review of reviews
Authors: Tang, J.
Abraham, C.
Greaves, C.
Yates, Tom
First Published: 19-Feb-2014
Publisher: Journal of Medical Internet Research
Citation: Journal of Medical Internet Research, 2014;16(2):e58
Abstract: BACKGROUND: A wide range of self-directed weight-loss interventions are available, providing users with a variety of tools delivered through various formats to regulate weight-related behavior patterns. However, it is unclear how effective self-directed interventions are and how they promote weight loss and weight maintenance. OBJECTIVE: A systematic review of reviews was conducted to examine the effectiveness of such interventions and to identify intervention content associated with effectiveness. METHODS: MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library for systematic reviews were searched from 2000-2012 for reviews of the effectiveness of self-directed interventions on weight loss and weight maintenance in adults. Two reviewers used predefined inclusion criteria to select relevant reviews and assess their quality using the Overview Quality Assessment Questionnaire (OQAQ). We extracted data on effectiveness and on relationships between intervention characteristics and effectiveness. RESULTS: Twenty reviews were included and quality assessed. Findings relevant to self-directed interventions, including interactive websites, smartphone applications, and text messaging (short message service, SMS) were summarized. Findings were mixed but promising. For example, one review of Internet-based interventions found that, when used in conjunction with standard weight loss programs, these interventions resulted in a significant average increase in weight loss of 1.5 kg over evaluation periods. Unfortunately, only 7 of 20 reviews were of high methodological quality according to OQAQ scores, and only 4 employed meta-analyses. Few reviews linked intervention content to effectiveness. CONCLUSIONS: Current evidence suggests that self-directed interventions can independently promote weight loss and can augment interventions involving personal contact. Particular change techniques and delivery modes including individualized feedback, email counseling, and online social support appear to enhance effectiveness. Further reviews of the content of self-directed weight-loss intervention studies are needed to clarify which change techniques delivered through which delivery formats optimize intervention effectiveness.
DOI Link: 10.2196/jmir.2857
ISSN: 1439-4456
eISSN: 1438-8871
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: ¬©Jason Tang, Charles Abraham, Colin Greaves, Tom Yates. Originally published in the Journal of Medical Internet Research (, 19.02.2014. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Description: PMCID: 3961624
Appears in Collections:Published Articles, Dept. of Medical and Social Care Education

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