Small steps

Is a small change approach effective for weight management?

Making small changes to diet and/or participation in physical activity each day may be an effective strategy for preventing weight gain.

We searched ten databases to identify randomised controlled trials where the authors stated they had tested a small change approach for weight management or where an intervention that aimed decrease energy intake and/or increase energy expenditure by up to 200kcals per day was used. We screened trials and extracted and summarised data from eligible trials.

The review found a small change approach to diet and/or physical activity may be effective in preventing weight gain in adults, with an average of 0.7-0.9 kg of weight gain prevented over a follow-up of eight to 14 months. A small change approach may therefore be an appropriate strategy to reduce the 0.5 to 1 kg of average adult weight gain seen each year and may lead to decreased prevalence of overweight and obesity over time. 

What next?

Although this review shows that a small change approach may be effective for preventing adult weight gain, most trials had some methodological concerns which should be addressed in future research. Additionally, most trials included intensive, multicomponent interventions that may not be suitable for implementation within the UK public health system. Future research should therefore aim to develop brief small change interventions that can be delivered in a range of settings. 

Citation details

Graham HE, Madigan CD, Daley AJ. Is a small change approach for weight management effective? A systematic review and meta‐analysis of randomized controlled trials. Obesity Reviews. 2021. DOI: 10.1111/obr.13357


Amanda Daley is supported by a National Institute for Health Research (NIHR) Research Professorship award. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care

Find out more about our work in brief interventions and making every contact count

Our researchers

Henrietta Graham

Henrietta Graham

Research Associate

Claire Madigan

Dr Claire Madigan

Senior Research Associate, Weight management interventions

Amanda Daley

Professor Amanda Daley

Professor of Behavioural Medicine, Centre Director