(P15-028-24) A Systematic Review of the Effectiveness of Meal Provision for Weight Loss Among Adults With Overweight or Obesity

Objectives: Overweight/obesity (OW/OB) with its multi-factor causes, affects 42% of US adults. A promising avenue of research aimed at the diet-related causes of OW/OB is Food is Medicine (FIM), which targets access to consistently healthful food and nutrition. FIM approaches include grocery, produce, and meal provision crafted to treat specific medical conditions. There remains a gap in knowledge related to the overall efficacy, dose, and duration of FIM interventions. To address this gap, we conducted a systematic review to assess the evidence base for interventions of meal provision for weight loss in adults with OW/OB.

Methods: In September 2023, PubMed, Embase, Cochrane, and CINAHL databases were searched for relevant articles. We included articles in English detailing randomized controlled trials (RCTs) lasting greater than 12 weeks and designed to examine body composition as measured by weight, BMI, fat mass index, and/or body fat in free-living adults (≥ 18 years) with a BMI ≥ 25kg/m2. Exclusion criteria included subjects who were pregnant or lactating, persons with HIV or cancer, and the provision of meal replacements (shakes or bars), and grocery/produce alone. All articles were double-screened and conflict resolution was done by a third reviewer. Analysis encompassed a risk of bias assessment and data synthesis based upon study characteristics such as delivery and meal composition, dropout rates (DOR), and primary and secondary outcomes.

Results: We screened 9612 items retrieved from databases resulting in 98 full text reviews. We identified 12 unique RCT studies that met the criteria. The majority of studies (8) reported significant changes in weight compared to controls. Interventions ranged from 12 weeks to 18 months, with three reporting follow-up periods of 12 months after intervention. The number of participants ranged from 36 to 458; and DOR ranged from 1% to 66%. Other outcomes included blood pressure (n=6); lipids (n=6); and less than half reported glucose, gut biomarkers, or mood/quality of life/physical function measures.

Conclusions: The few meal provision studies for weight loss to date reflect varied intervention approaches related to the duration, number of meals, and meal composition. These findings illustrate the need for greater consensus in order to tailor plans for weight loss among people with OW/OB.

Funding Sources: UAB NORC, NIH, NIDDK, NIMHD