Table 4.

Descriptive summary of eligible intervention studies

Author (Year)	Country	Age, range in years and mean (SD)	Sample Size	Participants	Study Design	Intervention Description	The Timing of the Measurements	Outcome Measurement	Main Findings	Limitations in Articles	Recommendations in Articles
Al‐Sarraj et al (2009)96	Emirates	18‐50	56 after dropout 39 (14 males and 25 female)	Emiratis with metabolic syndrome	Randomized trial comparing two diets	Carbohydrate restriction diet vs carbohydrate restriction diet followed by the conventional low‐fat diet (3 mo)	At baseline, week 6, and week 12	Fasting plasma lipids, 24‐h dietary recalls, body composition, anthropometric, blood pressure, glucose, insulin, and plasma markers of inflammation	After 6 wk, reduced body weight (−13%), waist circumference (−4.5%), and body fat (−10.6%) were shown. After 12 wk, positive changes continued for all participants following the diet. However, body weight was lower in the carbohydrate restriction diet group than in the carbohydrate restriction diet followed by the conventional low‐fat diet group.	‐	‐
Yar (2008)97	Saudi Arabia	18‐25	106	Saudi male university students in medicine and allied medical sciences	Posttest study	Experiment in physiology course (2 wk, two sessions, 2 h per session)	At the end of the second session	Motivation to increase physical activity, increase healthy eating habits, and increase knowledge about obesity	74% of students were motivated to engage in more physical activity, 63% of students to adopt healthier eating habits, and 67% of students to enhance their knowledge about obesity. Furthermore, students were motivated to actively engage in the measurement of their BMI.	It is hard to evaluate if intention (reported change in thinking) about the modification of lifestyle will translate into a change in behaviour of the participating students.
Sadiya et al (2016)98	Emirates	18‐50	45	Emirati females with obesity or with obesity and type 2 diabetes	Pretest‐posttest study	LIFE‐8: dietary intervention, physical activity intervention, and behavioural therapy (eight sessions of education and counselling, five in groups, three or more individual sessions)	At baseline, month 3 and follow‐up at month 12	Body weight, fat mass, waist circumference, blood pressure, fasting blood glucose, haemoglobin A1c, and nutritional knowledge	The intervention resulted in a reduction of 5.0% in body weight (4.8 ± 2.8 kg; 95% CI, 3.7‐5.8), fat mass (−7.8%, P < 0.01), and waist circumference (Δ = 4 ± 4 cm, P < 0.01) in the participants who completed the intervention (n = 28). Increase in nutritional knowledge (less than 0.01) and overall evaluation of the programme (9/10) was favourable. On 1‐y follow‐up, the participants could sustain weight loss (−4.0%).	Small sample size. There is no control intervention programme and the sample included only women.	Additional evidence from a randomized, controlled trial is essential to evaluate the short‐term and long‐term clinical advantages and cost‐effectiveness of the LIFE‐8 programme in this region. Since it is an ongoing programme, further studies with a larger sample size could provide insight into the generalizability of the results.
Midhet and Sharaf (2011)99	Saudi Arabia	20 and older	Baseline 1254 (70.7% males, 29.4% female) and follow‐up 1011 (65.3% males, 34.7% female)	Primary health care centres' visitors	Pretest‐posttest study with different samples at pretest and posttest	Health education intervention (10 mo)	At baseline and at month 10	Knowledge level, unhealthy dietary habits, regular exercise, and smoking	The intervention resulted in a decrease in the consumption of kabsa, bakery items, and dates and an increase in fish and fresh vegetables. Participants were less likely to smoke and more likely to do regular exercise. No significant impact of the intervention on the female population with regard to exercise.	Uncontrolled pretest‐posttest, with different samples at pretest and posttest.	Promoting healthy lifestyles and informing the public on the hazards of leading a sedentary life, and engaging in unhealthy practices is the only way to control and contain the unprecedented increase in lifestyle related diseases in Saudi Arabia.
Albassam et al (2007)100	Saudi Arabia	18‐40	212	Saudi females attending diet clinics	Pretest‐posttest study	Weight management programmes: four different diet programmes and one physiotherapy exercise programme	At baseline, and at the end of each programme (varies from 6 wk up to 10 mo)	Weight loss (%)	Moderate hypocaloric plan diet had, compared with the other four groups, the lowest per cent weight loss (7.8%) and the least side effects. Both groups under very low‐calorie diets and protein diets had the highest per cent weight reduction (13.2% and 12.3%) with the highest number of side effects.	‐	Use of the primary approach for achieving weight loss through therapeutic life style change is recommended.
Alghamdi (2017)101	Saudi Arabia	20 and older	140 (70 males, 70 female)	Arab participants with obesity who were otherwise healthy	Randomized controlled trial	Intensive lifestyle intervention (ILI) programme; diet, exercise, and behavioural techniques using goal setting, self‐monitoring, and stimulus control (eight visits) vs active comparator programme (received only an initial health education session)	At baseline and follow‐up at month 3	Weight loss (%)	Participants in ILI programme more often achieved a 5% weight reduction and showed significantly greater weight loss at 3 mo than the active comparator group.	High attrition rates, 36% of the participants dropped out of this study. No follow‐up for a longer period.	Similar programmes are needed to be implemented in the region. Further research is essential to evaluate the long‐term effectiveness of ILI among obese population and to identify effective methods for long‐term weight‐loss maintenance.
Armitage et al (2017)102	Kuwait	30.11(11.2)	216 (61 males, 127 female, 28 unknown)	Participants enrolled in a weight‐loss programme	Randomized controlled trial	Weight‐loss intervention programme using volitional help sheet to form implementation intentions vs the control group (use the volitional help sheet to think about critical situations and appropriate responses)	At baseline and at month 6	Weight loss (%)	At 6 mo, the intervention group lost significantly more weight (6.15 kg; −6.58% initial body weight) than those in the control group (3.66 kg; −4.04% initial body weight).	No follow‐up for a longer period, small sample size; all subjects were in treatment, and they were highly motivated to lose weight, no published protocol or data analysis plan prior to data collection, bias due to simple randomization method.	‐