Key Practice Point
#1
Recommendation
Interventions that include diet, physical activity and behavioural components are likely successful in reducing short-term BMI, BMI z-score and weight in children and adolescents with overweight or obesity. These interventions may also increase quality of life in adolescents.
There is mixed evidence regarding the effect of behavioural interventions on self-esteem in adolescents, with some studies showing no effect and some showing a beneficial effect. Behavioural interventions may also improve depressive symptoms, anxiety symptoms, disordered eating behaviours, body satisfaction and decreased internalization of female norms in this population.
Type of intervention, setting (e.g. health care, community, school), parental involvement, mode of delivery (i.e. individual or group) and duration of follow up did not appear to affect weight-related outcomes.
Evidence Summary
A 2017 Cochrane review found that diet, physical activity and behavioural interventions led to small reductions in BMI, BMI z-score, and weight in children aged six to 11 years with overweight or obesity compared to no intervention or usual care. Type of intervention, setting (e.g. health care, community, school), parental involvement and duration of follow up did not affect these results. Follow-up duration did not exceed two years in any included study.
A separate 2017 Cochrane review also found that diet, physical activity and behavioural interventions reduced BMI, BMI z-score and weight in adolescents aged 12 to 17 years with overweight or obesity compared to no intervention or usual care. Interventions improved quality of life but not self-esteem in this population. Results were not affected by type of intervention, parental involvement, setting (e.g. health care, community, school) or mode of delivery (i.e. individual or group). Follow-up duration did not exceed two years in any included study.
A 2019 systematic review and meta-analysis found small reductions in depressive and anxiety symptoms in children and adolescents <18 years undergoing obesity treatment interventions.
A 2017 systematic review examining the holistic (e.g. physiological as well as psychological) effect of weight loss interventions found two studies that suggested that adolescents (aged 12 to 18 years) who underwent combined diet, exercise and behavioural/psychological interventions saw improvements in depressive symptoms, disordered eating behaviours, body satisfaction and decreased internalization of female norms compared to control groups.
Grade of Evidence C
Remarks
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