Tools for Practice Outils pour la pratique


#312 Thirsty for weight loss ideas? Water for weight loss


CLINICAL QUESTION
QUESTION CLINIQUE
 Does increasing water lead to meaningful weight loss?

BOTTOM LINE
RÉSULTAT FINAL
 The effects of water on weight are uncertain due to inconsistent results, in small-moderate size studies with widely variable designs and compliance issues. Replacing caloric beverages with diet beverages or water inconsistently improved weight loss and differences between diet beverages and water was even less clear. Preloading water (500ml) before meals may improve weight loss by 1-2kg over 3 months.


CFPCLearn Logo

Reading Tools for Practice Article can earn you MainPro+ Credits

La lecture d'articles d'outils de pratique peut vous permettre de gagner des crédits MainPro+

 Join Now S’inscrire maintenant

Already a CFPCLearn Member? Log in

Déjà abonné à CMFCApprendre? Ouvrir une session


EVIDENCE
DONNÉES PROBANTES
  • Only randomized controlled trials (RCTs) presented. Results statistically different unless noted. Baseline BMI 31-36 (76-101kg).
  • Increasing water:
    • Two RCTs (38 adolescents; 240 women consuming ~400 calories/day from sugary drinks) comparing counselling +/- advice to drink water.1,2 After 24-36 weeks:
      • Weight loss: Not different.
    • One trial provided water (2-3L/day).1
    • Only 1/19 achieved target water intake in 1 RCT.2
  • Replacing caloric beverages:
    • Adherence counselling plus replacing >2 caloric beverages with water or diet beverages versus weight loss advice3: 318 patients consuming ~350 calories/day from sugary drinks. After 6 months:
      • Weight loss: Not different.
      • >5% weight loss: 20% (water/diet beverages) versus 11% (advice), number needed to treat (NNT)=11.
  • Replacing diet beverages:
    • Cognitive behavioral therapy with continued diet beverages or water4,5: 303 patients consuming ~700mL of beverages daily. After 52 weeks:
      • Weight loss: 6kg (diet beverages) versus 2kg (water).
      • Funder: American Beverage Association.
    • Hypocaloric diet +/- replacing diet beverages with water6,7: 71 women. After 18 months:
      • Weight loss: 0.1kg (diet) versus 1.7kg (diet + water).
    • Similar RCT6,7: 81 women. After 24 weeks:8
      • Weight loss: 5.3kg (diet) versus 6.4kg (diet + water).
  • “Pre-loading” water (500mL, 30 minutes before meals):
    • Hypocaloric diet +/- water9: 48 patients. After 12 weeks:
      • Weight loss: 7.4kg (pre-loaded water) versus 5.5kg (diet).
    • Water versus “imagining being full”10: 84 patients. After 12 weeks:
      • Weight loss: 2.4kg (pre-loaded water) versus 1.2kg (imagining).
      • >5% weight loss: 27% (pre-loaded water) versus 5% (imagining), NNT=5.
  • Systematic review found similar.11
Context
  • Obesity guidelines do not provide recommendations for water intake.12,13
  • Limitations included compliance issues2 and analyzing only study completers.9

Bhooma Bhayana April 10, 2022

interesting how this conflicts with “common wisdom” to drink more water

Moira McDowall April 17, 2022

Some weight loss with water for meal may help a bit

Latest Tools for Practice
Derniers outils pour la pratique
program image
Allison Paige MD CCFP

#364 Facing the Evidence in Acne, Part II: Oral Antibiotics

How effective are oral antibiotics in treating acne of at least mild-moderate severity?
Read Lire 0.25 credits available Crédits disponibles
program image
Bradley LeDrew PharmD candidate

#363 Making a difference in indifference? Medications for apathy in dementia

In patients with dementia, how safe and effective are stimulants, antidepressants, and antipsychotics for treating apathy?
Read Lire 0.25 credits available Crédits disponibles
program image
Allison Paige MD CCFP

#362 Facing the Evidence in Acne, Part I: Oral contraceptives and spironolactone in females

How effective are combined oral contraceptives (COC) and spironolactone for treating acne of at least mild-moderate severity in females?
Read Lire 0.25 credits available Crédits disponibles
April 4, 2022

This content is certified for MainPro+ Credits, log in to access

Ce contenu est certifié pour les crédits MainPro+, Ouvrir une session
Author(s)
Auteur(s)
  • Danielle Perry RN MSc
  • Karenn Chan MD CAC COE

1. Hernandez-Cordero S, Barquera S, Rodriquez-Ramirez S, et al. J Nutr. 2014; 144:1742-52.

2. Wong JMW, Ebbeling CB, Robinson L, et al JAMA Pediatr. 2017; 171(5):e170012.

3. Tate DF, Turner-McGrievy G, Lyons E, et al. Am J Clin Nutr. 2012; 95:555-63.

4. Peters JC, Wyatt HR, Foster GD, et al. Obesity. 2014; 22(6):1415-21.

5. Peters JC, Beck J, Cardel M, et al. Obesity. 2016; 24:297-304.

6. Madjd A, Taylor MA, Delavari A, et al. Am J Clin Nutr. 2014; 102:1305-12.

7. Madjd A, Taylor MA, Delavari A, et al. Int J Obes (Lond). 2018; 42(4):835-40.

8. Madjd A, Taylor MA, Delavari A, et al. Diabetes Obes Metab. 2017; 19(1):125-32.

9. Dennis EA, Dengo AL, Comber DL, et al. Obesity (Silver Spring). 2010; 18(2):300-7.

10. Parretti HM, Aveyard P, Blannin A, et al. Obesity. 2015; 23(9):1785-91.

11. Bracamontes Castelo G, Bacardí Gascón M, Jiménez Cruz A. Nutr Hosp. 2019; 36(6):1424-9.

12. Canadian Task Force on Preventive Health Care. CMAJ. 2015;187(3):184-195.

13. Wharton S, Lau DCW, Vallis M, et al. CMAJ. 2020; 192(4):E875-91.

Authors do not have any conflicts of interest to declare.

Les auteurs n’ont aucun conflit d’intérêts à déclarer.