Interventions for treating obesity in children

Summerbell, Carolyn; Ashton, V; Campbell, Karen; Edmunds, Laurel; Kelly, Sarah; Waters, Elizabeth

doi:10.1002/14651858.cd001872

Cited by 351 publications

(379 citation statements)

References 80 publications

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Section: Discussionmentioning

confidence: 99%

“…27 For a qualitative comparison with other interventions we refer readers to the most recent Cochrane systematic review. 27 Compared with exercise effects on adult obesity, our summary effect of B3 kg reduction on body weight over 14 weeks is comparable to that reported in the only meta-analysis we found in adults of Efficacy of exercise for treating overweight in youth E Atlantis et al exercise-only studies. 85 However, we cannot infer that exercise is equally effective for treating both overweight children/adolescents and adults, given the few numbers of studies included in our review, and that the meta-analysis by Miller et al 85 included studies that were conducted in normal and overweight subjects, and additional methodological and validity concerns were raised in a recent quality assessment of this review.…”

Section: Discussionmentioning

confidence: 99%

“…Bibliographies of these studies were also searched to extract further studies from those already retrieved, including a number of recent reviews. 21,23,26,27 Inclusion and exclusion criteria All studies published in English (because funding was not available for translation) that met the following criteria were included in this review: (1) studies were RCTs, (2) cohorts were of children or adolescents (aged o18 years) defined as being overweight/obese, (3) pre-and post-test or change in any overweight outcome was reported, (4) at least one exercise or physical activity treatment arm was investigated either in isolation or as an adjunct to an alternative treatment simultaneously prescribed to the control/comparison group (e.g., exercise plus caloric intake of 1000 kcal/days vs caloric intake of 1000 kcal/days). Studies which reported previously published data, or which included normal weight subjects in either treatment and/or comparison/ control groups were excluded, as well as nonrandomized trials.…”

Section: Methodsmentioning

confidence: 99%

“…Previous reviews have not critically assessed the quality of studies included, all of which also included nonrandomizedcontrolled trials, or studies which did not isolate the effects of exercise, or studies in normal weight cohorts. [21][22][23][24][25][26][27] In this systematic review and meta-analysis, we critically examined the quality of studies included and their effects on overweight outcomes in overweight children and adolescents, and we focused exclusively on randomized-controlled trials (RCTs) in which the isolated effects of exercise could be determined.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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Background: Overweight prevalence among children/adolescents is increasing, while adult obesity may potentially cause a decline in life expectancy. More exercise is uniformly recommended, although treatment efficacy remains unclear. Objective: To determine the efficacy of exercise alone for treating overweight in children/adolescents. Design: A systematic review and meta-analysis of randomized trials published in English were completed following multiple database searches performed on December 10, 2004. Studies of isolated or adjunctive exercise/physical activity treatment in overweight/obese children or adolescents which reported any overweight outcome were included. Literature searches identified 645 papers which were manually searched, of which 45 were considered for inclusion, of which 13 papers which reported 14 studies were included (N ¼ 481 overweight boys and girls, aged B12 years). Two reviewers independently identified relevant papers for potential inclusion and assessed methodological quality. Principal measures of effects included the mean difference (MD) (between treatment and control groups), the weighted MD (WMD), and the standardized MD (SMD). Results: Few studies were of robust design. The pooled SMD was À0.4 (À0.7, À0.1, P ¼ 0.006) for percent body fat, and À0.2 (À0.6, 0.1, P ¼ 0.07) for central obesity outcomes, whereas the pooled WMD was À2.7 kg (À6.1 kg, 0.8 kg, P ¼ 0.07) for body weight, all of which favored exercise. Pooled effects on body weight were significant and larger for studies of higher doses, whereas nonsignificant and smaller effects were seen for studies of lower doses of exercise (155-180 min/weeks vs 120-150 min/ weeks). Conclusions: Based on the small number of short-term randomized trials currently available, an aerobic exercise prescription of 155-180 min/weeks at moderate-to-high intensity is effective for reducing body fat in overweight children/adolescents, but effects on body weight and central obesity are inconclusive. Recommendations for future study designs are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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“…9,10 Nutrition, physical activity and behavior-modifying techniques have been components of the programs. However, according to recent reviews, 11,12 most published studies on obesity in children have been rather small, with homogenous motivated groups enrolled in hospital settings. Therefore, the results are poorly generalized at the population level.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling

2007

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Objective: The aim of the study was to compare the efficacy of group treatment stressing a health-promoting lifestyle with routine counseling in the treatment of childhood obesity. Design and subjects: Seventy obese children (weight for height 115-182%) aged 7-9 years were randomized either to routine counseling (two appointments for children) or to family-based group treatment (15 separate sessions for parents and children). These sessions included nutrition education, physical activity education and behavioral therapy. Outcome measures: Children's weights and heights were measured at baseline, after the 6-month intervention and after the 6-month follow-up. The change of weight for height based on Finnish growth charts was used as the primary, and changes in body mass index (BMI) and BMI standard deviation scores (BMI-SDS) as secondary outcome measures. Results: Children attending the group treatment lost more weight for height (6.8%) than children receiving routine counseling (1.8%) (P ¼ 0.001). The difference was significant when the data were analyzed in four groups by the cut-off limits of 0, À5 and À10% for the change in weight for height. The respective decreases in BMI were 0.8 vs 0.0 (P ¼ 0.003) and in BMI-SDS 0.3 vs 0.2 (P ¼ 0.022). The results remained similar in adjusted analyses. Both group and routine programs were feasible with a high, 87-99%, participation rate in sessions and appointments and very low, 3% or less, attrition rate from the programs. Six months after the intervention, beneficial effects were partly lost, but for changes in weight for height and BMI, the differences between the two treatment programs still were significant, and for BMI-SDS, there was a trend. Conclusions: Family-based group treatment that stresses a health-promoting lifestyle and is given separately for parents and children, offers an effective mode of therapy to treat obese school-aged children.

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Measuring Effectiveness of Dietetic Interventions in Child Obesity

Collins¹,

Warren²,

Neve³

et al. 2006

Arch Pediatr Adolesc Med

141

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It is not possible to evaluate the effectiveness of dietary treatment for childhood obesity because of the lack of high-quality studies and the heterogeneity of designs, treatment combinations, outcome measures, and follow-up. There is an urgent need to improve the quality of studies in this area because childhood obesity poses major health risks for populations, yet there is limited evidence on which to base treatment strategies.

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Interventions for treating obesity in children

Cited by 351 publications

References 80 publications

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling

Measuring Effectiveness of Dietetic Interventions in Child Obesity

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