EffectS of Lifestyle Interventions in Older PEople With Obesity (Effective SLOPE): a Systematic Review With Network Meta-Analyses

Torbahn G, Schöne D, Ernst I, Schwingshackl L, Rücker G, Knüttel H, Kemmler W, Sieber C, Batsis J, Villareal D, Stroebele-Benschop N, Volkert D, Kiesswetter E (2026)

Publication Type: Journal article, Review article

Publication year: 2026

Journal

DOI: 10.1111/obr.70123

Abstract

Background/Aim: We conducted a systematic review with network meta-analyses (NMA) summarizing the effects and safety of lifestyle interventions containing nutrition (NUT; e.g., calorie restriction), exercise (EX; e.g., aerobic/resistance exercise) and behavior change interventions (BCI; e.g., behavioral therapy) on physical function, body composition, quality of life, psychosocial outcomes, health and adverse events in community-dwelling older adults with obesity. Methods: We used the methodology proposed by Cochrane and searched six databases and one trial registry for eligible randomized controlled trials (RCTs; intervention duration ≥ 12 weeks) up to May 2022 with a full new search in MEDLINE and a re-assessment of previously identified eligible trial registry entries in October 2025. Random-effects NMA ((standardized) mean difference ((S)MD), 95% confidence intervals) were conducted if possible. Results: We included 72 RCTs (n = 6716) for descriptive summaries and 54 RCTs (n = 4249) for NMA. NUT+EX+BCI improved physical function (performance batteries) compared to control (SMD 3.37 [1.76;4.97]; high certainty of evidence). NUT+EX+BCI may reduce body (MD −8.69 [−13.14;−4.25]) and fat mass (MD −6.58 [−10.44;−2.73]) while not negatively affecting fat-free mass (MD −1.38 [−3.52;0.76]) or bone mineral density (MD −0.01 [−0.05;0.02]) (evidence very uncertain). Other interventions (single/combined) may also be effective; however, effects were often imprecise. For psychosocial outcomes, quality of life, and health events, data were insufficient or too heterogeneous to derive clear results. Conclusion: The evidence suggests that NUT+EX+BCI interventions are most suitable for the management of obesity in older adults. Nevertheless, further RCTs—especially in frail populations and on patient-relevant outcomes—are needed.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Freiburg Germany (DE) Universität Regensburg Germany (DE) University of North Carolina at Chapel Hill United States (USA) (US) Baylor College of Medicine United States (USA) (US) Universität Hohenheim Germany (DE)

How to cite

APA:

Torbahn, G., Schöne, D., Ernst, I., Schwingshackl, L., Rücker, G., Knüttel, H.,... Kiesswetter, E. (2026). EffectS of Lifestyle Interventions in Older PEople With Obesity (Effective SLOPE): a Systematic Review With Network Meta-Analyses. Obesity Reviews. https://doi.org/10.1111/obr.70123

MLA:

Torbahn, Gabriel, et al. "EffectS of Lifestyle Interventions in Older PEople With Obesity (Effective SLOPE): a Systematic Review With Network Meta-Analyses." Obesity Reviews (2026).

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