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Interventions to prevent or manage obesity in Māori and Pacific adults: a systematic review and narrative synthesis

Making Education Easy

From Māori Health Review Issue 104
Authors:
  • Mack M et al.
Summary:

Modest weight loss or no weight gain after several years may reduce progression to diabetes and improve glycaemic control in Māori and Pasifika adults with diabetes, according to a systematic review of 21 obesity intervention studies. Studies chosen for inclusion were heterogenous, with most graded as low quality. A total of 18 studies were eligible for quantitative analysis and five for qualitative analysis. Small but statistically significant improvements in weight and body mass index were reported in some studies. Social connection, sustainable lifestyle changes, culturally-centred interventions and incentives including money and enjoyment were key enablers. Barriers included difficulty in maintaining adherence with a programme due to factors such as lack of social support and malfunctioning or lost equipment. The study authors recommend urgent implementation of Māori and Pasifika-led weight loss programmes that promote sustainable lifestyle changes delivered in culturally and socially appropriate contexts.

Comment:
Surprising that there hasn’t been a systematic review yet on this topic. And given the low quality of studies, perhaps unsurprising that we are not able to provide excellent, evidence-based advice to people seeking help to lose weight. Small and sustainable changes may be useful for moderate weight loss, but surgical interventions may be the only option for many. With wait-times already incredibly long, and inequities in access to surgery for Māori, it was worrying to hear one bariatric surgeon describe efforts to address these with an equity-based tool as ‘problematic’.
Reference: Ethn Health. 2023;28(4):562-585.
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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