ROMEO

ROMEO: Systematic reviews and integrated report on the quantitative and qualitative evidence base for the management of obesity in men

Simultaneous systematic reviews of the literature on evidence-based management strategies for treating and engaging men in obesity services, by integrating the quantitative, qualitative and health economic evidence base were undertaken. Interventions included in the reviews included lifestyle interventions (diet and physical activity) and drug treatment (Orlistat).

Outcome and Translation

Based on all the literature reviewed, the study concluded that weight reduction for men is best achieved and maintained with the combination of a reducing diet, physical activity advice or a physical activity programme, and behaviour change techniques. Tailoring interventions and settings for men may enhance effectiveness, though further research is needed to better understand the influence of context and content.

No studies set out to determine the cost-effectiveness of treatment exclusively for men. However five studies reported results for subgroups of men. Interventions were grouped into lifestyle interventions (three studies) and Orlistat (two studies). The retrieved studies showed promising evidence of cost-effectiveness, especially when interventions were targeted at high-risk groups, such as those with impaired glucose tolerance. There appears to be some sex-specific elements to cost-effectiveness, although there were no clear trends or indications of what may be contributing to this. 

The economic evidence was highly uncertain, and limited by variable methodological quality of the included studies. Future studies are required to demonstrate the cost-effectiveness of interventions specifically targeted towards weight loss for men.

A best practice guide was produced by Public Health England and the Men's Health Forum based on the research findings of the RoMEO project.

Wilkins, D. (2014) How to....make weight-loss services work for men, London: Men's Health Forum.

HERU researchers involved in this research project: Dwayne Boyers (HERU)

External Collaborators: A Avenell, (HSRU, University of Aberdeen); F Douglas (Population Health, University of Aberdeen) and P Hoddinott (University of Stirling)

Publications

Robertson, C., Archibald, D., Avenell, A., Douglas, F., Hoddinott, P., Van Teijlingen, E., Boyers, D., Stewart, F., Boachie, C., Fioratou, E., Wilkins, D., Street, T., Carroll, P. and Fowler, C. (2013) Systematic reviews and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men. Report submitted to NIHR HTA Programme.

Robertson, C., Archibald, D., Avenell, A., Douglas, F., Hoddinott, P., Van Teijlingen, E., Boyers, D., Stewart, F., Boachie, C., Fioratou, E., Wilkins, D., Street, T. and Carrol, P. and Fowler, C. (2014) 'Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men', Health Technology Assessment, 18(35).

Stewart, F., Fraser, C., Robertson, C., Avenell, A., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E. and Boyers, D. (2014) 'Are men difficult to find?: Identifying male-specific studies in MEDLINE and Embase', Systematic Reviews, 3(1), 78.

Boyers, D., Avenell, A., Stewart, F., Robertson, C., Archibald, D., Douglas, F., Hoddinott, P. and van Teijlingen, E. (2015) 'A systematic review of the cost-effectiveness of non-surgical obesity interventions in men', Obesity Research & Clinical Practice, 9(4), 310-327.

Robertson, C., Avenell, A., Boachie, C., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E. and Boyers, D. (2015) 'Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: the ROMEO project', Obesity Research & Clinical Practice, 10(1), 70-84.

Robertson, C., Avenell, A., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E. and Boyers, D. (2017) 'Clinical effectiveness of weight loss and weight maintenance interventions for men: a systematic review of men-only randomized controlled trials (The ROMEO Project)', American Journal of Men's Health, 11(4), 1096-1123.

Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Stewart, F., Robertson, C., Boyers, D. and Avenell, A. (2015) 'A qualitative evidence synthesis on the management of male obesity', BMJ Open, 5(10), e008372.

Avenell, A., Robertson, C., Stewart, F., Boyers, D., Douglas, F., Archibald, D., van Teijlingen, E., Hoddinott, P. and Boachie, C. (2016) 'Sex can affect participation, engagement, and adherence in trials' (letter), BMJ, 355, i6754.

Presentations

Boyers, D., Stewart, F. and Avenell, A. (2013) 'Evaluating the cost-effectiveness of new interventions in the management and treatment of obesity: lessons for good practice evaluations from the ROMEO project', [poster] European Conference on Obesity (ECO), Liverpool, May 2013.

Robertson, C. F., Archibald, D., Avenell, A., Douglas, F., Hoddinott, P., Van Teijlingen, E., Boyers, D., Stewart, F., Boachie, C. and Fioratou, E. (2013) 'Using a combined realist and socio-ecological approach to integrating quantitative and qualitative systematic review evidence in a health technology assessment setting', 21st Cochrane Colloquium, Quebec, 19-23 September 2013.

Archibald, D. , Douglas, F., Hoddinott, P., Van Teijlingen, E., Robertson, C. F., Stewart, F., Boyers, D. and Avenell, A. (2013) 'A mixed-method evidence synthesis on the management of male obesity: the ROMEO (Review Of MEn and Obesity) project', Scottish Faculty of Public Health Conference, Dunblane, 7-8 November 2013.

Boyers, D., Avenell, A., Stewart, F., Robertson, C., Archibald, D., Douglas, F., Hoddinott, P. and van Teijlingen, E. (2014) 'Evaluating the cost-effectiveness of interventions for the management and treatment of obesity in men – results from the ROMEO study' [poster], Men's Health and Wellbeing: Critical Insights Conference, Leeds, 7-8 July 2014.

Robertson, C., Avenell, A., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D. and the ROMEO Project Group (2014) 'Should weight loss programmes be designed differently for men? A systematic review of long-term weight loss randomised controlled trials: the Romeo project' [poster], Men's Health and Wellbeing: Critical Insights Conference, Leeds, 7-8 July 2014.

Hoddinott, P., Archibald, D., Robertson, C., Stewart, F., Boyers, D., Douglas, F., van Teijlingen, E. and Avenell, A. (2014) 'Obesity in men: evidence synthesis findings and their implications for primary care. The ROMEO (Review of Men and Obesity) Project', Society for Academic Primary Care, Edinburgh, 9-12 July 2014.

Boyers, D., Avenell, A., Stewart, F., Robertson, C., Archibald, D., Douglas, F., Hoddinott, P. and van Teijlingen, E. (2014) 'A systematic review of the cost-effectiveness of non-surgical obesity interventions in men' [poster], Association for the Study of Obesity, UK Congress on Obesity, Birmingham, 16-17 September 2014.

Robertson, C., Avenell, A., Boachie, C., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E. and Boyers, D. (2014) 'Should weight loss programmes be designed differently for men and women? The ROMEO (Review of Men and Obesity) project', Association for the Study of Obesity, UK Congress on Obesity, Birmingham, 16-17 September 2014.

Robertson, C., Avenell, A., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E. and Boyers, D. (2014) 'A systematic review of long-term weight management randomised controlled trials for obese men: the ROMEO project [poster]', Association for the Study of Obesity, UK Congress on Obesity, Birmingham, 16-17 September 2014.

Robertson, C., Avenell, A., Stewart, F., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E. and Boyers, D. (2014) 'A systematic review of weight loss interventions for obese men in the UK: the ROMEO project' [poster], Association for the Study of Obesity, UK Congress on Obesity, Birmingham, 16-17 September 2014.