A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work.

Abstract

This meta-analytic review summarizes obesity prevention programs and their effects and investigates participant, intervention, delivery, and design features associated with larger effects. A literature search identified 64 prevention programs seeking to produce weight gain prevention effects, of which 21% produced significant prevention effects that were typically pre to post effects. Larger effects emerged for programs targeting children and adolescents (versus preadolescents) and females, programs that were relatively brief, programs solely targeting weight control versus other health behaviors (e.g., smoking), programs evaluated in pilot trials, and programs wherein participants must self-select into the intervention. Other factors, including mandated improvements in diet and exercise, sedentary behavior reduction, delivery by trained interventionists, and parental involvement, were not associated with significantly larger effects. A Meta-Analytic Review of Obesity Prevention Programs for Children and Adolescents: The Skinny on Interventions that WorkObesity in adulthood results in an increased risk for future death from all causes, coronary heart disease, atherosclerotic cerebrovascular disease, and colorectal cancer, as well as serious medical problems, including hyperlipidemia, hypertension, gallbladder disease, and diabetes mellitus (Calle, Thun, Petrelli, Rodriguez, & Heath, 1999). Obesity in childhood and adolescence is also associated with serious medical problems, including high blood pressure, adverse lipoprotein profiles, diabetes mellitus, atherosclerotic cerebrovascular disease, coronary heart disease, colorectal cancer, and death from all causes, as well as lower educational attainment and poverty (Dietz, 1998). The prevalence of obesity has increased sharply over the last three decades; currently 65% of adults are classified as overweight or obese (Hedley et al., 2004). The prevalence of obesity has risen even more sharply among adolescents and young adults (Hedley et al., 2004), which is alarming because obesity persists into adulthood for 70% of obese adolescents (Magarey, Daniels, Boulton, & Cockington, 2003). Obesity also carries a high fiscal cost; roughly $100 billion per year is spent on obesityrelated health care (Wolf, 1998).Unfortunately, successful treatments for obesity have been elusive. For adults, the current treatment of choice only results in about a 10% reduction in body weight and virtually all patients regain this weight within a few years of treatment . Obesity treatments for children and adolescents have yielded similar effects, though behavioral familybased interventions have produced more persistent weight loss effects (Epstein, Valoski, Wing, Correspondence should be addressed to Eric Stice, who is currently at Oregon Research Institute, 1715 Franklin Blvd., Eugene, Oregon, 97403. Email: estice@ori.org. Eric Stice, Heather Shaw, Department of Psychology, University of Texas at Austin. C. Nathan Marti, Department of Educational Administration, University of Tex...

Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis

“…This effect size corresponds to 21.3% non-overlap between the intervention and the control conditions according to Cohen's interpretation. 60 Results of the analyses of studies using TV reduction, nutrition alone and physical activity alone should be interpreted cautiously, as only one study was available in each category. Nevertheless, these results indicate that the major contributing factor to the success of combination nutrition and physical activity interventions may be the nutrition component.…”

“…A recent meta-analytic review of 64 obesity prevention programs (46 trials) for children and adolescents showed that 79% of programs did not produce statistically reliable weight-gain-prevention effects. 60 Another systematic review examining interventions for childhood obesity prevention also reported that the majority of studies reviewed did not have a significant impact. 22 These results suggest that the demonstration of weight loss among overweight children may be more easily attainable than the demonstration of the prevention of weight gain.…”

Do you see what I see? Weight status misperception and exposure to obesity among children and adolescents

“…8 Obesity prevention interventions targeting these lifestyle behaviors (that is, increasing physical activity and improving diet) have had limited success, as the establishment of healthy behaviors is difficult to sustain in the long term. [9][10][11] In a recent Cochrane review of 22 randomized controlled trials, Summerbell et al 9 found that childhood obesity prevention interventions resulted in no reduction of overweight (that is, body mass index (BMI)) and only modest improvements in changing diet or exercise behaviors in the short term. 9 Nonetheless, modification of these lifestyle behaviors continues to be recommended for obesity prevention in children.…”

Randomized trial of a brief depression prevention program: An elusive search for a psychosocial placebo control condition

“…Although CBT prevention programs have produced promising findings, the duration of these interventions makes them challenging to implement in schools. Thus, the first aim of the present study was to develop and evaluate a briefer CBT intervention in the hope that its shorter duration would increase its appeal to adolescents and ease of implementation, facilitating subsequent dissemination.We developed a targeted intervention because prevention trials for depression, eating disorders, obesity, aggression, and substance abuse suggest that intervention effects are stronger for people with elevated symptoms versus the general population (Horowitz, & Garber, 2006;Stice & Shaw, 2004;Stice, Shaw, & Marti, 2006). Those who are struggling with elevated symptoms may be more motivated to engage in prevention programs and may more easily acquire the intervention skills by applying them to their current experiences.…”

“…We developed a targeted intervention because prevention trials for depression, eating disorders, obesity, aggression, and substance abuse suggest that intervention effects are stronger for people with elevated symptoms versus the general population (Horowitz, & Garber, 2006;Stice & Shaw, 2004;Stice, Shaw, & Marti, 2006). Those who are struggling with elevated symptoms may be more motivated to engage in prevention programs and may more easily acquire the intervention skills by applying them to their current experiences.…”