APPENDIX II. DESCRIPTION OF EVIDENCE

A. Why Treat Overweight and Obesity?

Blood Pressure

To evaluate the effect of weight loss on blood pressure and hypertension, 76 articles reporting randomized controlled trials (RCTs) were reviewed. Of these, 60 were lifestyle trials that studied diet and/or physical activity and 16 were pharmacotherapy trials of anorexiants. The 60 lifestyle trials were: (346-352, 354-380, 405, 470, 473, 484, 490, 674-694).

The 16 articles on pharmacotherapy trials of anorexiants were: (386-395, 512, 695-699).

Lifestyle Trials

Of the 60 lifestyle trials reviewed, 35 were accepted and 25 were not included for these reasons:

• The no-treatment control group also lost weight (470, 473, 484, 490, 675-680, 683, 684, 688, 690, 692, 693);
• There was no appropriate control group (687);
• The dropout rate was more than 35 percent (685, 686);
• The results were not compared according to randomized treatment assignments (681);
• The population at baseline was not overweight (689-691);
• Blood pressure was not reported as a primary or secondary outcome (405); or
• The intervention period was less than 4 weeks (674).

Pharmacotherapy Trials

Of the 16 pharmacotherapy trials reviewed, 10 were accepted and 6 were not included because:

• The drug that was tested is not recommended for weight loss (695) [ephedrine alone] (696) [a beta-adrenoreceptor agonist] (697) [ephedrine combined with caffeine] (698) [testosterone] (699) [cimetidine], or
• Only very short-term data are available (512).