Effectiveness and Feasibility of Interventions for Weight Management of Young Adults in Low- and Middle-Income Countries (LMICs): A Systematic Review With Meta-Analysis

Abstract

Introduction: Overweight and obesity rates are rising globally, including among young adults, posing significant health risks. However, prevention programs in low- and middle-income countries (LMICs) are limited, and little is known about their applicability in these settings. This systematic review aimed to assess the effectiveness and feasibility of overweight and obesity prevention and management interventions among young adults in LMICs. Methods: Databases, including Medline, Scopus, and Web of Science, were systematically searched to identify trials published between 2014 and February 2026. Studies were included if they targeted young adults in LMICs and reported outcomes such as body mass index (BMI) and/or waist circumference. Publications reporting feasibility outcomes were manually searched. A random-effects meta-analysis estimated the mean difference in outcomes by gender and intervention duration. A narrative synthesis complemented the random-effects meta-analysis. The Cochrane risk-of-bias tool and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) framework evaluated the evidence quality. Results: Sixteen intervention studies met inclusion criteria, but none reported on feasibility. Nine studies were included in the meta-analysis on effectiveness. Pooled estimates show that mean BMI (kg/m2) (−1.13; 95% CI: −2.10, −0.17) and waist circumference (cm) (−1.66; 95% CI: −2.35, −0.96) were significantly lower in the intervention group compared to the controls. Greater effects were observed in longer durations of interventions (≥ 6 months). The quality of evidence was moderate. Conclusion: Obesity control interventions may benefit young adults in LMICs, but evidence is limited and moderate in quality. Future studies should evaluate feasibility using established implementation frameworks.