A triplet of weight loss

This week not one, not two, but three trials of programmes for weight loss.

It's difficult to get one's head around so much information, but the PICO approach can help: for each paper get clear in your mind (ok, so put it on a piece of paper) the

Target Population (e.g. Body Mass Index > 30 / BMI >30 plus other risk factors)

Exact Intervention (group sessions / telephone support etc )

Comparator and

Outcome (weight loss at 3 months / 24 months etc).

Ideally you would wait for a systematic review to put it all together but we don't always have that luxury: we need to make up our own minds now.

A question raised by all of these trials is whether a weight loss of, say, 5% is worth having. In public health we tend to take the view that even small changes can add up to huge benefit at population level. The concept of '"minimal important difference" is taken very seriously in planning clinical trials: the smallest difference which is worth having from the patient's point of view.  

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