Effectiveness of lifestyle interventions in preventing harmful weight gain among adolescents: A systematic review of systematic reviews

Abstract

Obesity in adolescence is associated with stigma during school years, early emergence of co-morbidities in adulthood and premature mortality. Adolescence presents a key window of opportunity to intervene for building healthy eating and physical activity routines and prevent weight gain. This review of reviews assesses the evidence on the effectiveness of prevention interventions conducted with adolescents. Nine reviews assessing the effects of lifestyle interventions in adolescents (defined as age 10 to 19 years old) on weight gain were identified from the 10 health databases searched. Only four reviews conducted meta-analyses, of which, three (two exercise-focused) demonstrated positive changes in primary outcomes of body mass index (BMI) and/or BMI z-score (range of decrease in BMI from 0.06 to 0.47 kg/m 2)). Most were conducted in school settings, and all but two reviews were of low quality. Few reviews reported external validity components that would enable clearer directions for policy makers to implement in real-world settings. More than 140 distinct interventions were included in the reviews, but there remains a serious gap in evidence for effective interventions in adolescents.

Parent Involvement in Diet or Physical Activity Interventions to Treat or Prevent Childhood Obesity: An Umbrella Review

“…Two previous umbrella reviews have demonstrated the effectiveness of lifestyle interventions for the treatment of child and adolescent obesity [ 29 , 30 ], with one of the reviews focused on family-based treatment interventions [ 30 ]. Prevention-focused umbrella reviews are inconsistent about whether interventions are effective for preventing child and adolescent obesity [ 24 , 31 , 32 , 33 ]. There are differences in age ranges of the systematic reviews within those umbrella reviews, which may explain some of the inconsistency in findings.…”

Enabling Better Nutrition for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents

“…The failure of interventions to generate any effect on the incidence of obesity in adolescents [11], especially those from ethnic minority backgrounds [10], has warranted the identification of other potential factors influencing obesity rates in this at-risk population. Factors such as SES, diet acculturation, and food insecurity highlight the need for a localised approach to be implemented with policies targeting social disadvantages and interventions rooted in culture-specific traditional dietary habits to be researched and conducted.…”

“…Risk behaviours included more frequent eating in front of the television (37% vs. 19%), more unrestricted snacking (73% vs. 50%), and a lower likelihood of meeting the recommended daily intake of vegetables (3% vs. 11%). Such a disproportionate distribution of obesity, associated lifestyle risk behaviours, and inadequacy of interventions targeting adolescents, from ethnic minority backgrounds [10,11], illuminates the need for evidence-based, culturally relevant, and locally designed lifestyle programs.…”

Enabling Better Physical Activity and Screen Time Behaviours for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents

“…Despite these trends, obesity prevention research is lacking in recruiting adolescents from ethnic minorities [ 7 ] and/or in analysing and reporting findings by ethnic group. Furthermore, the majority of interventions have failed to produce sustained weight management [ 8 ].…”

“…Physical activity behaviours have been shown to track into adulthood [ 11 ], with lower levels linked with a predisposition for overweight and obesity as well as for other co-morbidities [ 12 ] and risk factors such as hypertension [ 13 ]. Furthermore, there is preliminary evidence supporting exercise-focused interventions for adolescents [ 8 ].…”