Background: Behavioural weight management interventions that assess eating disorder symptoms show an average reduction or no change in symptoms over time. There is a need to examine whether these interventions also achieve the common goal of weight loss.
Aims: This study aimed to examine change in body mass index (BMI) for adults in behavioural weight management trials that assessed eating disorder symptoms compared to no-treatment control and based on intervention intensity.
Methodology: This secondary analysis used individual participant data (IPD) from the Eating Disorders In weight-related Therapy (EDIT) Collaboration. This included behavioural weight‑management interventions that assessed eating‑disorder symptoms in people with overweight/obesity. Change in BMI was examined through 1) two-stage pairwise meta-analyses comparing any intervention to no-treatment control at 12-months post-baseline, and 2) two-stage network meta-analyses based on low, medium, or high intervention intensity at post-intervention. Intervention intensity categories reflected the dose (duration and frequency of contact), and breadth of behaviour change content and strategies (e.g. diet, physical activity) used.
Results: Of the 36 trials (k) in the EDIT Collaboration dataset, 9 were eligible (n=1679; mean age=48.5 years; BMI=32.2 kg/m²; 81% female). Pairwise meta-analyses revealed a significant reduction in BMI (k=2; n=529 MD= -2.04, 95%CI -3.41, -0.67, tau=1.07) compared to no-treatment control. Network meta-analyses (k=9, n=1679) found a significant reduction in BMI for high (MD= -2.62, 95%CI -3.63, -1.61), medium (MD= -1.07, 95%CI –2.06, -0.08) and low (MD= -1.33, 95%CI -2.55, -0.11) intensity interventions, compared to control.
Conclusion: Relative to no treatment, receiving any behavioural weight management intervention resulted in clinically meaningful weight loss at 12 months post-baseline, with high intensity interventions having the greatest reduction in BMI at post-intervention. Behavioural weight management interventions that assessed eating disorder symptoms were associated with favourable weight-related outcomes alongside potential decreased eating disorder symptoms.