Abstract
BACKGROUND: The "Weight Management Year" (2024-2026) is a key national policy in China that prioritizes community-based strategies to combat the growing obesity epidemic. However, a comprehensive synthesis of global evidence on the effectiveness of community-led interventions, which could inform the implementation of this policy, remains lacking. METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. Eight electronic databases were searched from January 1, 2015, to April 30, 2025. We included randomized controlled trials (RCTs), cluster-RCTs, and other high-quality experimental or observational studies (eg, quasi-experimental studies, service evaluations) assessing non-pharmacological, community-based weight management interventions in diverse global settings, with a focus on extracting insights applicable to China's context. Meta-analyses were performed for body weight and BMI outcomes where data were available. RESULTS: Fifteen studies were included in the qualitative synthesis, with seven providing data for meta-analysis. The pooled results showed that community-led interventions were effective in improving several health outcomes. A meta-analysis of four RCTs (n = 641) on body weight change did not show a statistically significant reduction overall (MD: -1.16 kg, 95% CI: -3.19 to 0.86). However, a meta-analysis of six RCTs (n = 1376) demonstrated a statistically significant reduction in body mass index (MD: -1.57 kg/m(2), 95% CI: -2.74 to -0.39). Beyond anthropometrics, evidence from large-scale and culturally adapted studies across different countries indicated that such interventions also reduced cardiovascular risk, improved blood pressure and glycemic control, and enhanced health behaviors. CONCLUSION: Synthesizing global evidence within the framework of China's "Weight Management Year" indicates that community-led strategies-including digital health, multi-sector collaboration, and cultural adaptations-are effective in achieving short- to medium-term health improvements. To fully realize the policy's potential, future efforts in China should focus on institutionalizing successful models adapted from international experience, strengthening frontline capacity, and ensuring long-term sustainability.