Losing 10 pounds in 3 days is an unrealistic goal for most people and could entail unsafe dieting behaviors. Rapid weight loss like this may also make it more likely that someone will put weight back on, rather than losing the weight permanently.

To lose 20 pounds in a month, people must burn more calories than they take in, either through dietary changes or increased physical activity. However, rapid weight loss like this may not be a viable long-term option and could increase the risk of health complications, such as gallstones.

Losing weight too quickly may also increase the risk of certain health complications, such as gallstones, or complications associated with unhealthy dieting behaviors, such as dehydration or nutritional deficiencies. People who experience rapid weight loss may be more likely to put weight back on in the future.

The CDC recommends that people aim for steady, gradual weight loss of around 1—2 pounds per week. This should include 10 portions of fruit and vegetables, good quality protein, and whole grains. It is also beneficial to exercise for at least 30 minutes every day.

Losing weight effectively and avoiding weight regain involves a number of factors. Learn how to lose weight here.

Fad diets and rapid weight loss can be unsafe and often lead to people regaining the weight later on. In this article, learn how to lose weight safely…. People often want to lose weight quickly, but there is a risk of malnourishment, or of giving up and putting on more weight than before.

What are the best exercises for weight loss? Find out the best types of exercise for weight loss, according to research, and get other useful tips. Losing 10 pounds safely is possible in 5—10 weeks or more.

Creating a calorie deficit, eating a nutritious diet, and moving more are important factors. My podcast changed me Can 'biological race' explain disparities in health? Why Parkinson's research is zooming in on the gut Tools General Health Drugs A-Z Health Hubs Health Tools Find a Doctor BMI Calculators and Charts Blood Pressure Chart: Ranges and Guide Breast Cancer: Self-Examination Guide Sleep Calculator Quizzes RA Myths vs Facts Type 2 Diabetes: Managing Blood Sugar Ankylosing Spondylitis Pain: Fact or Fiction Connect About Medical News Today Who We Are Our Editorial Process Content Integrity Conscious Language Newsletters Sign Up Follow Us.

Medical News Today. Health Conditions Health Products Discover Tools Connect. How to naturally lose weight fast. Medically reviewed by Amy Richter, RD , Nutrition — By Tracey Williams Strudwick — Updated on November 8, Intermittent fasting Tracking diet and exercise Mindful eating Protein with meals Avoid sugar Fiber Gut bacteria balance Sleep Managing stress FAQ Takeaway Many diets, supplements, and meal replacement plans claim to ensure rapid weight loss, but lack any scientific evidence.

Science-backed ways to lose weight. Trying intermittent fasting. Tracking your diet and exercise. Eating mindfully. Eating protein with meals.

Cutting back on sugar and refined carbohydrates. Eating plenty of fiber. Balancing gut bacteria. Kandula, N. Translating a heart disease lifestyle intervention into the community: the South Asian Heart Lifestyle Intervention SAHELI study; A randomized control trial.

BMC Public Health 15 , Article CAS PubMed PubMed Central Google Scholar. Salas-Salvadó, J. Effect of a lifestyle intervention program with energy-restricted Mediterranean Diet and exercise on weight loss and cardiovascular risk factors: One-year results of the PREDIMED-Plus Trial.

Diabetes Care 42 , — Blackford, K. Home-based lifestyle intervention for rural adults improves metabolic syndrome parameters and cardiovascular risk factors: A randomised controlled trial. Röhling, M. Weight reduction by the low-insulin-method—a randomized controlled trial.

Nutrients 12 , 1— Article CAS Google Scholar. Pablos, A. Effects of a lifestyle intervention program for treating obesity in lower socioeconomic status adults: a randomized controlled trial. Gazzetta Medica Italiana Archivio Per Le Scienze Mediche , — Article Google Scholar. Cai, R.

Effect of community-based lifestyle interventions on weight loss and cardiometabolic risk factors in obese elderly in China: A randomized controlled trial.

Malakou, E. The combined effect of promoting the mediterranean diet and physical activity on metabolic risk factors in adults: A systematic review and meta-analysis of randomised controlled trials.

Montesi, L. Long-term weight loss maintenance for obesity: a multidisciplinary approach. Diabetes Metab. McCambridge, J. Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. Índice de masa corporal población adulta según sexo y grupo de edad.

Roser, H. Alvarez León, E. Med Clin Barc , — Rose, G. Sick individuals and sick populations. Strategy of prevention: Lessons from cardiovascular disease.

van Namen, M. Supervised lifestyle intervention for people with metabolic syndrome improves outcomes and reduces individual risk factors of metabolic syndrome: A systematic review and meta-analysis. Metabolism , Cano-Ibáñez, N. Diet quality and nutrient density in subjects with metabolic syndrome: Influence of socioeconomic status and lifestyle factors.

A cross-sectional assessment in the PREDIMED-Plus study. Cano-Ibanez, N. Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: Results from the PREDIMED-Plus Study.

Christian, J. Interpreting weight losses from lifestyle modification trials: using categorical data. Download references. Professor Khan is a Distinguished Investigator at the University of Granada funded by the Beatriz Galindo senior modality program of the Spanish Ministry of Education.

Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Campus de la Salud.

de la Investigación 11, , Granada, Spain. Preventive Medicine Unit, Universitary Hospital Virgen de Las Nieves, Granada, Spain. CIBER de Epidemiología Y Salud Pública CIBERESP-Spain , Madrid, Spain. Instituto de Investigación Biosanitaria de Granada IBS. GRANADA , Granada, Spain.

You can also search for this author in PubMed Google Scholar. All authors contributed in the conception of the research question and designed the study. did the literature search, study selection and data extraction, and double checked by P.

and A. did the statistical analysis. The figures, tables and appendices were designed by A. All authors contributed to the drafts and final version of the manuscript. Correspondence to Paloma Massó Guijarro.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The original online version of this Article was revised: The original version of this Article contained errors in the Funding section.

Full information regarding the correction made can be found in the correction for this Article. Open Access This article is licensed under a Creative Commons Attribution 4.

The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.

If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Reprints and permissions. Bouzalmate Hajjaj, A. A systematic review and meta-analysis of weight loss in control group participants of lifestyle randomized trials. Sci Rep 12 , Download citation.

Received : 10 February Accepted : 29 June Published : 18 July Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. By submitting a comment you agree to abide by our Terms and Community Guidelines.

If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Skip to main content Thank you for visiting nature. nature scientific reports articles article. Download PDF. Subjects Epidemiology Lifestyle modification Obesity Outcomes research Randomized controlled trials Weight management.

This article has been updated. Abstract Randomized clinical trials RCTs of lifestyle modification have reported beneficial effects of interventions, compared to control. Introduction Obesity, a major cause of morbidity and mortality worldwide with over million affected adults 1 , 2 , has attracted interest in preventive research of various study designs in light of its impact on the healthcare system and the economy 3 , 4.

Material and methods We performed the systematic review after prospective registration PROSPERO number: CRD and reported it in accordance with relevant guidelines Search and selection We conducted a comprehensive literature search without language restrictions in electronic databases Medline via ProQuest, Scopus, Web of Science, Cochrane library and Clinicaltrials.

Data extraction and risk of bias The key characteristics of selected studies were extracted independently by both reviewers ABH and PMG after reading the full text.

Data synthesis and statistical analysis We used the outcomes of the control groups reported by the authors as the mean difference in kg of body weight lost from baseline to post-participation and its standard deviations SD.

Results Study selection and quality assessment A total of records were identified initially. Figure 1. Full size image. Table 1 Characteristics of studies included in the review.

Full size table. Figure 2. Quality assessment of the studies included in the review using Jadad scale. Figure 3. Figure 4. Figure 5. Figure 6. Discussion Our meta-analysis of over four thousand participants combined showed that control groups in obesity research lost weight overall, confirming that it is safe and beneficial to participate in trials even if the allocation is not to the intervention arm.

Conclusions Our systematic review showed that participation in control groups of RCTs of lifestyle interventions had a benefit in terms of weight loss in meta-analysis with heterogeneity.

Data availability All data generated or analysed during this study are included in this published article Appendix 2 — 4. Abbreviations RCTs: Randomized controlled trials BMI: Body Mass Index. References Blüher, M. Article PubMed Google Scholar The Lancet, G. Article PubMed PubMed Central Google Scholar Tremmel, M.

Article PubMed Google Scholar Groeneveld, I. Article PubMed PubMed Central Google Scholar Lemstra, M. Article PubMed PubMed Central Google Scholar Mutsaerts, M. Article CAS PubMed Google Scholar Eaglehouse, Y.

Article PubMed PubMed Central Google Scholar Vist, G. Article CAS PubMed Google Scholar Clarke, M. Article PubMed PubMed Central Google Scholar Braunholtz, D. Article CAS PubMed Google Scholar Gross, C. Article PubMed PubMed Central Google Scholar Fernandes, N.

Article PubMed PubMed Central Google Scholar Waters, L. Article PubMed PubMed Central Google Scholar Glanz, K. Article CAS PubMed Google Scholar Stroup, D. Article CAS PubMed Google Scholar Moss, J. Article CAS PubMed Google Scholar Share, B.

Article PubMed Google Scholar Higgins, J. Article PubMed PubMed Central Google Scholar Deeks, J. Article PubMed Google Scholar Christensen, J. Article PubMed Google Scholar Puhkala, J. Article PubMed Google Scholar Weinhold, K.

Article PubMed PubMed Central Google Scholar Bo, S. Article PubMed Google Scholar Alghamdi, R. Article PubMed PubMed Central Google Scholar Kandula, N. Article CAS PubMed PubMed Central Google Scholar Salas-Salvadó, J.

Article CAS PubMed Google Scholar Blackford, K. Article PubMed Google Scholar Röhling, M. It can also contribute to metabolic changes, which may be dangerous for some with certain conditions such as diabetes.

The long-term health effects of a diet very low in carbohydrates but high in saturated fat is still uncertain. Further research is needed to determine the safety of these diets.

Also, the high amounts of saturated fat typically consumed in Keto diets increases the risk of elevated 'bad' LDL cholesterol and heart disease. Because the long-term safety of these diets is unknown, seek advice from your doctor or a dietitian as there is likely a safer and more sustainable way for you to lose weight.

Plenty of diets are based on the belief that the digestive system can't process a combination of foods or nutrients. Commonly, carbohydrates such as grain foods and proteins such as meat foods are incorrectly thought to 'clash', leading to digestive problems and weight gain.

The opposite is often true — foods eaten together can help the digestive system. Such as, vitamin C in orange juice can increase iron absorption from a meal rich in plant-based iron like beans and rice, lentils and other legumes.

Also, very few foods are purely carbohydrate or purely protein — most are a mixture of both. The digestive system has enzymes that are perfectly capable of breaking down all the foods we eat so single food diets should be avoided.

Some people believe some foods can help us lose weight — for instance, grapefruit, celery or kelp can burn fat or speed up metabolism. But this is not true. Fibre from food comes closest to having special dietary qualities, because it provides a feeling of 'fullness' with minimal kilojoules.

High-fibre foods such as fruit, vegetables, wholegrain breads and cereals and legumes are usually high in nutrients and low in unhealthy fats. The term 'superfood' gets used a lot but there is no standard definition of what a superfood must be. Most foods labelled as superfoods tend to be plant-based — acai berries, wheatgrass, spirulina, salmon, leafy greens, tea and turmeric.

Although typically packed with nutrients — vitamins, minerals and antioxidants — they have little energy. It is your overall dietary pattern that has the biggest impact on your health.

Not only will starving yourself result in feeling tired and lethargic, your body is more likely to miss out on essential nutrients.

Over the long term, skipping meals is unlikely to help with weight loss at all. The important thing to losing weight and keeping it off is to make small, achievable changes to your eating and exercise habits:.

Fasting has gained popularity with the diet, where for 5 days, people eat their usual diet and on the remaining 2 days, a very low energy diet is followed.

There are various versions of intermittent fasting, with some preferring to restrict energy on alternate days, alternate weeks or certain times of the day.

For example, following a plan — fasting for 16 hours of the day and eating for the other 8 hours. Fasting overnight until your first meal the next day could also be called a form of intermittent fasting break-fast. Evidence shows there is generally no difference in the amount of weight lost by following a fasting diet when compared with a traditional energy restriction diet.

As with any diet, being able to sustain it is key to losing and keeping off weight. Some research shows a healthy vegetarian dietary pattern, or a mainly plant-based diet, is associated with lower levels of obesity and reduced risk of health problems such as elevated blood pressure and heart disease.

But there are still many vegetarian food choices that can lead to weight gain, especially those that are high in fats and added sugars or if eaten in large amounts.

Going gluten-free for health is only for people with coeliac disease or those sensitive to gluten. By doing so, you may miss out on many of the vitamins, minerals and fibre from grains.

We need to drink fluids to avoid dehydration, and water is the best choice. It also does not contain any kilojoules energy like many other drinks. Plain milk is another great choice as it has many nutrients — along with the energy. Most other drinks have extra energy usually from added sugars without the health benefits of other nutrients.

These include:. And if energy from drinks is not used by our body it will be stored as fat. For instance:. Alcohol contains no nutrients and has almost as much energy as fat almost double carbohydrates and protein.

Also, when we drink alcohol our inhibitions tend to be lowered, making it more likely we will crave less healthy foods. There are benefits to choosing foods that are minimally processed. But there are also many other nutritious foods that will be missing from your diet if you eliminate whole food groups.

Be careful of products that claim to be organic. If choosing organic is important to select a variety of foods that fit within the Australian Guide to Healthy Eating External Link.

The amount of information available on food, diet and weight loss is endless and not much of it is credible or correct. Popular media is full of fad diets and magic weight loss potions endorsed by celebrities and supported by personal success stories.

Much of what is claimed is based on anecdotal rather than scientific evidence and, many times, there is something to be gained by the person or organisation behind the claim such as profit from sales. Unlike other fields where experts are trusted when it comes to nutrition and health, it seems that everyone is an expert.

If you would like to lose weight, a good start would be basing your diet on foods that fit within the Australian Guide to Healthy Eating External Link.

Or see a qualified health professional such as a dietitian who will give you dietary advice that is evidence-based, tailored to your nutritional and health needs and suits your lifestyle.

The best way to lose weight is slowly, by making small, achievable changes to your eating and exercise habits. Rather than being a slave to the number on the scales, be guided by your waist circumference — a healthy waist circumference is less than 94cm for men and less than 80cm for women.

Suggestions for safe and effective weight loss include:. Avoiding large portion sizes and limiting intake of saturated fats and added sugars will help to keep your energy intake in check.

If you are not sure where to start or finding it difficult to manage your weight, seek help from a dietitian. Dietitians can guide you to a healthy way of eating that is based on the latest research and tailored to suit your health and lifestyle. This page has been produced in consultation with and approved by:.

In practice, it is very similar to both the Mediterranean and DASH diets, but it puts stronger emphasis on leafy green vegetables and berries, and less emphasis on fruit and dairy.

In recent years, the Nordic diet has emerged as both a weight-loss and health-maintenance diet. Based on Scandinavian eating patterns, the Nordic diet is heavy on fish, apples, pears, whole grains such as rye and oats, and cold-climate vegetables including cabbage, carrots and cauliflower.

Studies have supported its use both in preventing stroke and in weight loss. What do all of these diets have in common? Eating for your health—especially your heart health—by adopting elements from these diets is a smart way to lose weight.

But is fasting healthy, and does intermittent fasting work? Fasting—abstaining from eating for some period of time—is an ancient practice that is safe when not taken to extremes.

Traditionally, the benefits of fasting have been both spiritual and physical. People who fast for religious reasons often report a stronger focus on spiritual matters during the fast.

Physically, a simple fast lowers blood sugar, reduces inflammation, improves metabolism, clears out toxins from damaged cells and has been linked to lower risk of cancer, reduced pain from arthritis and enhanced brain function. A common intermittent fasting schedule might restrict eating to the hours of a.

to p. But there is no specific, prescribed schedule. Some people have more or less generous eating windows, setting the rule that they will not eat after, say, p.

During a period without eating, insulin levels drop to the point that the body begins burning fat for fuel. Numerous studies have demonstrated the benefits of intermittent fasting for weight loss.

One possible reason for the success of intermittent fasting is that most practitioners have quit the habit of eating during the late evening and night hours. There are certain people who should not try intermittent fasting without first checking with their doctor, such those with diabetes or heart disease.

It sounds counterintuitive, but many people find success losing weight—especially initially—by eating more fat, not less. The theory is that by eating so many healthy fats and restricting carbohydrates, you enter an altered metabolic state in which you force your body to begin relying on fat for energy, burning away your fat stores instead of sugar for fuel.

Research does show that keto is an effective way to jump-start weight loss and improve blood-sugar levels.

However, it is hard to maintain, and to date we are lacking long-term studies that show it to be a sustainable eating pattern for keeping weight off. Because both weight loss and overall health are tied to some basic eating patterns, we have developed the Harvard Healthy Eating Plate as a model for meal planning and for your overall balanced diet.

Imagine a round dinner plate with a line running vertically down its center dividing it evenly in two. One half of the plate should be taken up by equal portions of whole grains not refined grains like white bread and white rice and healthy protein such as fish, nuts, beans and poultry—not red meat or processed meats.

Two-thirds of the other half should be filled with vegetables, with the remaining portion consisting of fruit. To the other side of the plate, imagine a vessel containing healthy oils such as canola or olive oil.

Use it for cooking or at the table instead of butter. Adhering to its guidelines will optimize your chances of remaining healthy and of maintaining a desirable body weight. Thanks for visiting. Don't miss your FREE gift.

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What's the healthiest diet? Trials 12 , Braunholtz, D. Are randomized clinical trials good for us in the short term? Gross, C. Does random treatment assignment cause harm to research participants?. PLoS Med. Fernandes, N. Outcomes for patients with the same disease treated inside and outside of randomized trials: A systematic review and meta-analysis.

CMAJ , E Waters, L. Weight change in control group participants in behavioural weight loss interventions: A systematic review and meta-regression study. BMC Med. Byrd-Bredbenner, C. Systematic review of control groups in nutrition education intervention research.

Act 14 , Glanz, K. The health impact of worksite nutrition and cholesterol intervention programs. Health Promot. Stroup, D. Meta-analysis of observational studies in epidemiology: A proposal for reporting.

Meta-analysis Of Observational Studies in Epidemiology MOOSE group. JAMA , — Jadad, A. Assessing the quality of reports of randomized clinical trials: Is blinding necessary?. Control Clin. Trials 17 , 1— Moss, J. Effects of a pragmatic lifestyle intervention for reducing body mass in obese adults with obstructive sleep apnoea: A randomised controlled trial.

BioMed Res. Oh, E. A randomized controlled trial of therapeutic lifestyle modification in rural women with metabolic syndrome: A pilot study. Share, B. Effects of a multi-disciplinary lifestyle intervention on cardiometabolic risk factors in young women with abdominal obesity: A randomised controlled trial.

PLoS ONE. Morris, S. Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Methods 7 , — Higgins, J. Measuring inconsistency in meta-analyses. BMJ , — Deeks, J. in Cochrane Handbook for Systematic Reviews of Interventions — McKenzie, J.

in Cochrane Handbook for Systematic Reviews of Interventions 33—65 Nanri, A. Effect of six months lifestyle intervention in Japanese men with metabolic syndrome: Randomized controlled trial.

Health 54 , — Christensen, J. Diet, physical exercise and cognitive behavioral training as a combined workplace based intervention to reduce body weight and increase physical capacity in health care workers—A randomized controlled trial. BMC Public Health. Thiabpho, C. Intensive lifestyle modification program on weight loss and metabolic syndrome risk reduction among obese women in rural areas of Thailand.

Health Res. Maruyama, C. Effect of a worksite-based intervention program on metabolic parameters in middle-aged male white-collar workers: A randomized controlled trial.

Puhkala, J. Lifestyle counseling to reduce body weight and cardiometabolic risk factors among truck and bus drivers—a randomized controlled trial. Work Environ. Health 41 , 54— Weinhold, K. A randomized controlled trial translating the diabetes prevention program to a university worksite, Ohio, — Preventing Chronic Disease.

Duijzer, G. Effect and maintenance of the SLIMMER diabetes prevention lifestyle intervention in Dutch primary healthcare: A randomised controlled trial. Fernández-Ruiz, V.

Effectiveness of the I 2 AO 2 interdisciplinary programme led by nurses on metabolic syndrome and cardiovascular risk: a randomized, controlled trial. Bo, S. Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial.

Anderson, A. A novel approach to increasing community capacity for weight management a volunteer-delivered programme ActWELL initiated within breast screening clinics: A randomised controlled trial.

Cai, H. Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease: A randomised controlled trial. BMC Gastroenterol. Greaves, C. Waste the waist: A pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk.

Lin, M. Tailored, interactive text messages for enhancing weight loss among African American Adults: The TRIMM randomized controlled trial. Alghamdi, R. A randomized controlled trial of a week intensive lifestyle intervention program at a primary care obesity clinic for adults in western Saudi Arabia.

Saudi Med. Kandula, N. Translating a heart disease lifestyle intervention into the community: the South Asian Heart Lifestyle Intervention SAHELI study; A randomized control trial.

BMC Public Health 15 , Article CAS PubMed PubMed Central Google Scholar. Salas-Salvadó, J. Effect of a lifestyle intervention program with energy-restricted Mediterranean Diet and exercise on weight loss and cardiovascular risk factors: One-year results of the PREDIMED-Plus Trial.

Diabetes Care 42 , — Blackford, K. Home-based lifestyle intervention for rural adults improves metabolic syndrome parameters and cardiovascular risk factors: A randomised controlled trial. Röhling, M. Weight reduction by the low-insulin-method—a randomized controlled trial.

Nutrients 12 , 1— Article CAS Google Scholar. Pablos, A. Effects of a lifestyle intervention program for treating obesity in lower socioeconomic status adults: a randomized controlled trial.

Gazzetta Medica Italiana Archivio Per Le Scienze Mediche , — Article Google Scholar. Cai, R. Effect of community-based lifestyle interventions on weight loss and cardiometabolic risk factors in obese elderly in China: A randomized controlled trial.

Malakou, E. The combined effect of promoting the mediterranean diet and physical activity on metabolic risk factors in adults: A systematic review and meta-analysis of randomised controlled trials. Montesi, L.

Long-term weight loss maintenance for obesity: a multidisciplinary approach. Diabetes Metab. McCambridge, J. Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects.

Índice de masa corporal población adulta según sexo y grupo de edad. Roser, H. Alvarez León, E. Med Clin Barc , — Rose, G. Sick individuals and sick populations. Strategy of prevention: Lessons from cardiovascular disease. van Namen, M.

Supervised lifestyle intervention for people with metabolic syndrome improves outcomes and reduces individual risk factors of metabolic syndrome: A systematic review and meta-analysis.

Metabolism , Cano-Ibáñez, N. Diet quality and nutrient density in subjects with metabolic syndrome: Influence of socioeconomic status and lifestyle factors. A cross-sectional assessment in the PREDIMED-Plus study. Cano-Ibanez, N. Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: Results from the PREDIMED-Plus Study.

Christian, J. Interpreting weight losses from lifestyle modification trials: using categorical data. Download references. Professor Khan is a Distinguished Investigator at the University of Granada funded by the Beatriz Galindo senior modality program of the Spanish Ministry of Education.

Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Campus de la Salud.

de la Investigación 11, , Granada, Spain. Preventive Medicine Unit, Universitary Hospital Virgen de Las Nieves, Granada, Spain. CIBER de Epidemiología Y Salud Pública CIBERESP-Spain , Madrid, Spain. Instituto de Investigación Biosanitaria de Granada IBS.

GRANADA , Granada, Spain. You can also search for this author in PubMed Google Scholar. All authors contributed in the conception of the research question and designed the study. did the literature search, study selection and data extraction, and double checked by P.

and A. did the statistical analysis. The figures, tables and appendices were designed by A. All authors contributed to the drafts and final version of the manuscript. Correspondence to Paloma Massó Guijarro. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original online version of this Article was revised: The original version of this Article contained errors in the Funding section. Full information regarding the correction made can be found in the correction for this Article. Open Access This article is licensed under a Creative Commons Attribution 4.

The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Reprints and permissions. Bouzalmate Hajjaj, A. A systematic review and meta-analysis of weight loss in control group participants of lifestyle randomized trials. Sci Rep 12 , Download citation. Received : 10 February Accepted : 29 June Published : 18 July Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. By submitting a comment you agree to abide by our Terms and Community Guidelines.

If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Skip to main content Thank you for visiting nature. nature scientific reports articles article. Download PDF. Subjects Epidemiology Lifestyle modification Obesity Outcomes research Randomized controlled trials Weight management.

This article has been updated. Abstract Randomized clinical trials RCTs of lifestyle modification have reported beneficial effects of interventions, compared to control. Introduction Obesity, a major cause of morbidity and mortality worldwide with over million affected adults 1 , 2 , has attracted interest in preventive research of various study designs in light of its impact on the healthcare system and the economy 3 , 4.

Material and methods We performed the systematic review after prospective registration PROSPERO number: CRD and reported it in accordance with relevant guidelines Search and selection We conducted a comprehensive literature search without language restrictions in electronic databases Medline via ProQuest, Scopus, Web of Science, Cochrane library and Clinicaltrials.

Data extraction and risk of bias The key characteristics of selected studies were extracted independently by both reviewers ABH and PMG after reading the full text. Data synthesis and statistical analysis We used the outcomes of the control groups reported by the authors as the mean difference in kg of body weight lost from baseline to post-participation and its standard deviations SD.

Results Study selection and quality assessment A total of records were identified initially. Figure 1. Full size image. Table 1 Characteristics of studies included in the review.

Full size table. Figure 2. Quality assessment of the studies included in the review using Jadad scale. Figure 3. Figure 4. Figure 5. Figure 6. Discussion Our meta-analysis of over four thousand participants combined showed that control groups in obesity research lost weight overall, confirming that it is safe and beneficial to participate in trials even if the allocation is not to the intervention arm.

Conclusions Our systematic review showed that participation in control groups of RCTs of lifestyle interventions had a benefit in terms of weight loss in meta-analysis with heterogeneity.

Data availability All data generated or analysed during this study are included in this published article Appendix 2 — 4. Abbreviations RCTs: Randomized controlled trials BMI: Body Mass Index. References Blüher, M. Article PubMed Google Scholar The Lancet, G. Article PubMed PubMed Central Google Scholar Tremmel, M.

Article PubMed Google Scholar Groeneveld, I. Article PubMed PubMed Central Google Scholar Lemstra, M. Article PubMed PubMed Central Google Scholar Mutsaerts, M. Article CAS PubMed Google Scholar Eaglehouse, Y. Article PubMed PubMed Central Google Scholar Vist, G.

Article CAS PubMed Google Scholar Clarke, M. Article PubMed PubMed Central Google Scholar Braunholtz, D. Article CAS PubMed Google Scholar Gross, C. Article PubMed PubMed Central Google Scholar Fernandes, N. Article PubMed PubMed Central Google Scholar Waters, L.

Article PubMed PubMed Central Google Scholar Glanz, K.

Many diets, supplements, and meal replacement plans claim to ensure rapid weight loss, but lack any scientific evidence. However, there are some strategies backed by science that have an impact on weight management.

These strategies include exercising, keeping track of calorie intake, intermittent fasting, and reducing the number of carbohydrates in the diet. Intermittent fasting IF is a pattern of eating that involves regular short-term fasts and consuming meals within a shorter time period during the day.

Several studies have indicated that short-term intermittent fasting up to 26 weeks in duration is as effective for weight loss as following a daily low calorie diet. It is best to adopt a healthy eating pattern on non-fasting days and to avoid overeating.

If someone wants to lose weight, they should be aware of what they eat and drink each day. One way to do this is to log these items in either a journal or an online food tracker.

Research suggests that tracking diet and exercise may be helpful for weight loss because it promotes behavior changes and increases motivation. One study found that consistent tracking of physical activity helped with weight loss.

Even a device as simple as a pedometer can be a useful weight-loss tool. Mindful eating is a practice where people pay attention to how and where they eat food.

This practice can enable people to enjoy the food they eat and may help to promote weight loss. As most people lead busy lives, they often tend to eat quickly on the run, in the car, working at their desks, and watching TV. As a result, many people are barely aware of the food they are eating.

Protein can regulate appetite hormones to help people feel full. This is mostly due to a decrease in the hunger hormone ghrelin and a rise in the satiety hormones peptide YY, GLP-1, and cholecystokinin. Research on young adults has also demonstrated that the hormonal effects of eating a high protein breakfast can last for several hours.

Good choices for a high protein breakfast include eggs, oats, nut and seed butters, quinoa porridge, sardines, and chia seed pudding. The Western diet is increasingly high in added sugars, which has definite links to obesity , even when the sugar occurs in beverages rather than food.

These include white rice, white bread, and regular pasta. These foods are quick to digest, and they convert to glucose rapidly. Excess glucose enters the blood and provokes the hormone insulin , which promotes fat storage in the adipose tissue.

This contributes to weight gain. A study links the consumption of more refined grains with weight gain. Studies show that whole grains are more likely to reduce hunger and increase fullness, which could lead to decreases in calorie intake.

Where possible, people should swap highly processed and sugary foods for more nutritionally dense options. Good food swaps include:. Dietary fiber describes plant-based carbohydrates that are impossible to digest in the small intestine, unlike sugar and starch. Including plenty of fiber in the diet can increase the feeling of fullness, potentially leading to weight loss.

One emerging area of research is focusing on the role of bacteria in the gut on weight management. The human gut hosts a vast number and variety of microorganisms, including around 39 trillion bacteria.

Every individual has different types and amounts of bacteria in their gut. Some types may increase the amount of energy the person extracts from food , leading to fat deposition and weight gain. Numerous studies have shown that getting fewer than 5—6 hours of sleep per night is associated with an increased incidence of obesity.

There are several reasons behind this. Research suggests that insufficient or poor-quality sleep slows down the process in which the body converts calories to energy, called metabolism. When metabolism is less effective, the body may store unused energy as fat.

In addition, poor sleep can promote insulin resistance and increase levels of cortisol, which also promote fat storage. How long someone sleeps also affects the regulation of the appetite-controlling hormones leptin and ghrelin. Leptin sends signals of fullness to the brain.

However, when people are under constant stress, cortisol can remain in the bloodstream for longer, which will increase their appetite and potentially lead to them eating more.

Insulin then transports the sugar from carbohydrates from the blood to the muscles and brain. If the individual does not use this sugar in fight or flight, the body will store it as fat.

If an individual does not immediately use this sugar, the body will either store it is glycogen, the storage form of glucose, or fat. Researchers found that implementing an 8-week stress-management intervention program alongside a low-calorie diet resulted in a significant reduction in the body mass index BMI of children and adolescents who were overweight or have obesity.

Losing 10 pounds in 3 days is an unrealistic goal for most people and could entail unsafe dieting behaviors. Rapid weight loss like this may also make it more likely that someone will put weight back on, rather than losing the weight permanently. To lose 20 pounds in a month, people must burn more calories than they take in, either through dietary changes or increased physical activity.

However, rapid weight loss like this may not be a viable long-term option and could increase the risk of health complications, such as gallstones.

The length of the follow-up ranged from 1 to 24 months. We considered as time points the end-point of the intervention provided by the authors. If these data were not available, post-intervention follow-up value was considered, like in one study 47 where outcomes were measured at 6 months, although the follow-up lasted up to 12 months.

The same criterion was applied to another study 29 , where the effects of only the first three months of intervention were reported, whilst the intervention lasted up to 12 months.

In two studies 32 , 35 the intervention was carried out during 12 months and, afterwards, the participants were followed up for other 12 months post-intervention.

Finally, in a RCT 21 the intervention lasted 3 months, although the follow-up was extended to 6,5 months. The lifestyle interventions were carried out by dietitians or nutritionists in three studies 33 , 42 , 47 , and in collaboration with other health professionals e.

Control groups received the standard or usual care, or were wait-listed to receive the lifestyle program after data collection in the RCT.

As the exploration of heterogeneity leads to more meaningful, high-value conclusions, we also performed a meta-analysis comparing subgroups by type of care protocols in control group.

Meta-analysis of weight loss outcome in control group participants in lifestyle randomized controlled trials. Meta-analysis of weight loss outcome in control group participants stratified by duration of follow-up in lifestyle randomized controlled trials. Meta-analyses of weight loss outcome in control group participants stratified by high-quality lifestyle randomized controlled trials.

Meta-analysis of weight loss outcome stratified by type of care protocols in control group participants in lifestyle randomized controlled trials. Our meta-analysis of over four thousand participants combined showed that control groups in obesity research lost weight overall, confirming that it is safe and beneficial to participate in trials even if the allocation is not to the intervention arm.

To our knowledge, this is the first systematic review and meta-analysis focusing on control group outcomes in lifestyle intervention studies.

Our findings confirm the hypothesis of health improvement of control participants, in contrast to the results on overall weight changes in a meta-regression study on behavioural weight loss interventions Our search was unrestricted, without limitations regarding language or dataset inception, to capture the highest possible number of relevant studies.

There was reviewer agreement in the search, selection and quality assessment of studies adding to reliability of our work. However, our main finding was within the limitations placed by heterogeneity. This is an expected, possibly unavoidable, limitation when addressing lifestyle interventions In our review there are various possible sources of heterogeneity.

Standard healthcare in control groups may vary between participants depending on the health systems in the countries where trials are carried out. We also found a diversity of approaches in handling control group engagement, e.

With a considerable sample size, we could precisely estimate the control group weight loss. The reporting of some of the studies did not facilitate the analysis of the control group, as findings were mainly reported for intergroup differences.

However, in the three mentioned articles not providing required parameters for meta-analysis, we were able to estimate them from the available data.

Despite the issues arising from data reporting quality, our overall result was statistically significant. How did the control group come to benefit? The observed benefits may be due to a trial effect, which increases adherence to care protocols 12 and encourages interaction between patients and professionals Additionally, Hawthorne effect could improve control group outcome through modification of the behaviour of research participants just because they are observed in the course of a trial The observed fact that the control groups benefit is generally in line with the view that participating in RCTs is good for participants 10 , 11 , This finding is particularly important as the prevalent overweight and obesity rates are high.

As the mean age of the control group participants in Spain 35 , 43 , 46 was 60 years, trial participation could be thought of as a strategy for weight control. Despite the magnitude of the effect in control group participants is not large, the fact that they experienced a weight loss inverses population trends of progressive gain during adult life According to the preventive paradox of Rose et al.

Health services should also consider implementing lifestyle intervention trials as part of programs for people with overweight and obesity Lifestyle research has shown health benefits of intervention compared to control in terms of adiposity and cardiovascular risk decrease 57 , Our findings also show a benefit in the outcome of the control groups.

Future research should examine if the benefits gained by participation in the control groups can be maintained over time as a healthy weight loss has a tendency to be gradually regained 48 , These benefits should be used to encourage participation in future obesity research to generate the timely evidence for practice and policy.

Our systematic review showed that participation in control groups of RCTs of lifestyle interventions had a benefit in terms of weight loss in meta-analysis with heterogeneity. That control groups accrue benefits should be included in patient information sheets to encourage participation in future trials among patients with overweight or obesity.

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