DataSheet_2_Comparative effectiveness of a low-calorie diet combined with acupuncture, cognitive behavioral therapy, meal replacements, or exercise for obesity over different intervention periods: A systematic review and network meta-analysis.zip

ObjectiveThe aim of this study was to evaluate the comparative effectiveness of a low-calorie diet (LCD) combined with acupuncture, cognitive behavioral therapy (CBT), meal replacements (MR), and exercise on weight loss.
MethodsThe electronic databases MEDLINE, EMBASE, CENTRAL, CNKI, RISS, and KISS were searched systematically. Randomized controlled trials (RCTs) that directly compared the effect of a low-calorie diet (LCD)-combined acupuncture, CBT, and exercise and an MR-based diet on weight loss with LCD-alone for adults with simple obesity (body mass index [BMI] > 25) published before August 2021 were included in the study. Two investigators extracted and coded the data using a template. Any disagreements between investigators were resolved through discussion. Changes in BMI or weight were transformed to Hedges’ g values with a 95% CI, and network meta-analyses using a Bayesian random-effects model were conducted.
ResultsA total of thirty-two trials involving 3,364 patients were finally included in the study. The effect sizes of four interventions were medium, in the order of acupuncture (Hedges’ g = 0.48, 95% CI = 0.25 - 0.71), CBT (Hedges’ g = 0.42, 95% CI = 0.20 - 0.63), MR (Hedges’ g = 0.32, 95% CI = 0.19 - 0.45), and exercise (Hedges’ g = 0.27, 95% CI = 0.06 - 0.46).
In terms of intervention period, acupuncture was effective in the short period (≤ 12 weeks, Hedges’ g = 0.39, 95% CI = 0.12 - 0.67) and the long period (>12 weeks, Hedges’ g = 0.89, 95% CI = 0.37 - 1.40), whereas CBT (Hedges’ g = 0.51, 95% CI = 0.26 - 0.76) and exercise (Hedges’ g = 0.37, 95% CI = 0.12 - 0.59) were effective only in the long period. MR was effective only in the short period (Hedges’ g = 0.35, 95% CI = 0.18 - 0.53).
ConclusionsThis study suggests that acupuncture, CBT, MR, and exercise for simple obesity show a medium effect size, and their effectiveness differs according to the intervention period.

研究目的：本研究旨在评估低热量饮食（low-calorie diet, LCD）分别联合针刺、认知行为疗法（cognitive behavioral therapy, CBT）、代餐（meal replacements, MR）及运动，与单纯低热量饮食相比，针对单纯性肥胖成人的减重效果差异。
研究方法：本研究系统检索了MEDLINE、EMBASE、CENTRAL、中国知网（CNKI）、RISS及KISS等电子数据库。纳入2021年8月之前发表的、针对单纯性肥胖（体重指数[body mass index, BMI]＞25）成人的随机对照试验（randomized controlled trials, RCTs），这些试验直接比较了联合针刺、CBT、运动的低热量饮食方案，以及基于代餐的饮食方案与单纯低热量饮食的减重效果。由两名研究者采用标准化模板提取并编码数据，研究者间的分歧通过讨论解决。将体重或BMI的变化量转换为带有95%置信区间（95% CI）的海德斯g值（Hedges’ g），并采用贝叶斯随机效应模型开展网络meta分析。
研究结果：最终共纳入32项试验，涉及3364名受试者。四种干预措施的效应量均为中等，排序依次为针刺（Hedges’ g=0.48，95% CI=0.25~0.71）、CBT（Hedges’ g=0.42，95% CI=0.20~0.63）、代餐（Hedges’ g=0.32，95% CI=0.19~0.45）及运动（Hedges’ g=0.27，95% CI=0.06~0.46）。按干预周期划分来看，针刺在短期（≤12周，Hedges’ g=0.39，95% CI=0.12~0.67）及长期（＞12周，Hedges’ g=0.89，95% CI=0.37~1.40）干预中均有效；而CBT（Hedges’ g=0.51，95% CI=0.26~0.76）与运动（Hedges’ g=0.37，95% CI=0.12~0.59）仅在长期干预中有效；代餐仅在短期干预中有效（Hedges’ g=0.35，95% CI=0.18~0.53）。
结论：本研究表明，针对单纯性肥胖的针刺、CBT、代餐及运动干预均呈现中等效应量，且其干预效果随干预周期不同而存在差异。