Effects of multidisciplinary interventions on weight loss and health outcomes in children and adolescents with morbid obesity

Abstract

There is not a 'one-size-fits-all' treatment approach, and matched care to personal needs is preferable. The integration of a chronic care approach is critical for the successful adaption of sustainable health behaviours.

A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research

“…There is a diversity of intervention and prevention strategies . They extend from community‐based approaches to a range of parent‐focused strategies and multifaceted interventions . There is evidence of modest effects, claims of no effects, effects that are small, although statistically significant, but lack clinical significance and “patchy” progress on prevention .…”

Partnering Support Interventions with Bariatric Surgery to Maximize Health Outcomes in Adolescents with Severe Obesity

“…There has been consistent evidence that comprehensive medium-to high-intensity behavioral treatment interventions in adolescents with obesity and overweight result in at least short-term benefits. Specifically, meta-analyses (25)(26)(27)(28) have confirmed the efficacy of comprehensive, behavioral, familybased interventions for pediatric obesity previously reported in a Cochrane Review (29). One meta-analysis of 29 behavioral studies in youth up to age 18 years showed significant short-term effects on BMI outcomes in favor of treatment (standardized mean difference: −0.54; 95% CI: −0.73 to −0.36) (27).…”

“…Pooled estimates for blood pressure and quality of life also showed significant improvement. A more recent meta‐analysis of 20 RCTs in youth up to age 18 examining behavioral interventions for obesity reached similar conclusions . The overall effect size for the interventions compared with controls was slightly lower but significant (Hedge’s g = 0.473; 95% CI: 0.362 to 0.584).…”

“…A total of 36 studies were found that met the search criteria. The majority of studies were reviews ( n = 16, Table ), 8 were observational, 7 were case‐control studies, 3 were quasi‐experimental/case‐control studies, and 2 were RCTs (1 was a methods paper only) (Table ). No studies that tested the combination of pharmacotherapy interventions with MBS were found.…”

“…All studies identified independent components of weight‐loss strategies but none specifically in combination or sequenced one after the other. For example, Zolotarjova et al assessed components that were included in previous articles (e.g., physical activity, nutrition education, family inclusion, behavioral modification, MBS); however, the review identified only one study, a single case report that explicitly assessed coordination of a healthy lifestyle program and MBS . As such, the authors concluded, “There is no consensus regarding the treatment of morbid obesity, as well as, for the outcomes to evaluate the possible effects of interventions.” They further pointed out the necessity to include a “healthy community environment” to support sustained weight loss and other positive health effects after MBS.…”