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Background <p>Overweight and obesity pose an escalating health challenge for the older, yet routine management (RM) often underperform due to fragmented care. The multidisciplinary weight management (MWM) intervention addresses this challenge by integrating family doctor team and sport-health integration. We aim to evaluate the effectiveness of RM versus MWM intervention on body mass index (BMI) and waist circumference (WC) among overweight / obese adults (aged ≥ 65 years).</p> Methods <p>A 24-month retrospective cohort study utilized electronic health records from Xiamen Basic Public Health Cloud Platform, including the MWM group (1177 samples) and the Routine Management (RM) group (1188 samples). McNemar χ² tests were employed to assess within-group changes in BMI and WC from baseline to post-intervention, while χ² tests compared BMI and WC between groups. The Wilcoxon signed-rank test and the Mann-Whitney U test were utilised to compare clinical indicators between the two groups before and after intervention, as well as to compare the two groups. Multivariable linear regression models were fitted to report the effect of MWM versus RM as β coefficients with 95% confidence intervals (CIs). Mediation analysis were conducted on physical activity level, smoking status and alcohol consumption. </p> Results <p>The MWM group showed more favorable shifts in BMI (normal weight 13.25% vs. 0.00%) and WC (no centrol obesity 42.57% vs. 32.15%) compared with RM (<i>P</i> &lt; 0.001). And MWM is associated with BMI and WC reduction, with a mean reduction in BMI of 0.88&#xa0;kg/m<sup>2</sup> (95% CI: 0.77 to 0.99; <i>P</i> &lt; 0.001) and in WC of 1.16&#xa0;cm (95% CI: 0.78 to 1.55; <i>P</i> &lt; 0.001). Physical Activity partially mediated the intervention effect on BMI (mediation proportion 6.78%; <i>P</i> = 0.032).</p> Conclusions <p>The MWM group produced clinically greater reductions in BMI and WC compared with RM, and its integrated care framework may offer an effective and scalable approach to obesity management in older adults. To promote this management, future research should validate in larger, diverse cohorts.</p> Graphical abstract <p></p>

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Long-term effectiveness of multidisciplinary weight management versus routine management on body mass index and waist circumference in older adults with overweight and obesity: a 24-month retrospective cohort study

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  • 发表日期：

    2026年2月6日

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  • Youlan Chen,
  • Linbin He,
  • Yanqi Lan,
  • Haixia Zhang,
  • Yizhen Hu,
  • Zhinan Guo

摘要

Background

Overweight and obesity pose an escalating health challenge for the older, yet routine management (RM) often underperform due to fragmented care. The multidisciplinary weight management (MWM) intervention addresses this challenge by integrating family doctor team and sport-health integration. We aim to evaluate the effectiveness of RM versus MWM intervention on body mass index (BMI) and waist circumference (WC) among overweight / obese adults (aged ≥ 65 years).

Methods

A 24-month retrospective cohort study utilized electronic health records from Xiamen Basic Public Health Cloud Platform, including the MWM group (1177 samples) and the Routine Management (RM) group (1188 samples). McNemar χ² tests were employed to assess within-group changes in BMI and WC from baseline to post-intervention, while χ² tests compared BMI and WC between groups. The Wilcoxon signed-rank test and the Mann-Whitney U test were utilised to compare clinical indicators between the two groups before and after intervention, as well as to compare the two groups. Multivariable linear regression models were fitted to report the effect of MWM versus RM as β coefficients with 95% confidence intervals (CIs). Mediation analysis were conducted on physical activity level, smoking status and alcohol consumption.

Results

The MWM group showed more favorable shifts in BMI (normal weight 13.25% vs. 0.00%) and WC (no centrol obesity 42.57% vs. 32.15%) compared with RM (P < 0.001). And MWM is associated with BMI and WC reduction, with a mean reduction in BMI of 0.88 kg/m2 (95% CI: 0.77 to 0.99; P < 0.001) and in WC of 1.16 cm (95% CI: 0.78 to 1.55; P < 0.001). Physical Activity partially mediated the intervention effect on BMI (mediation proportion 6.78%; P = 0.032).

Conclusions

The MWM group produced clinically greater reductions in BMI and WC compared with RM, and its integrated care framework may offer an effective and scalable approach to obesity management in older adults. To promote this management, future research should validate in larger, diverse cohorts.

Graphical abstract