Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta‐analysis

Jebeile, Hiba; Gow, Megan L.; Baur, Louise A.; Garnett, Sarah P.; Paxton, Susan J.; Lister, Natalie B.

doi:10.1111/obr.12866

Cited by 105 publications

(126 citation statements)

References 88 publications

(754 reference statements)

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“…This review, in combination with findings from two other reviews conducted by our team, demonstrates that treatment interventions for children and adolescents with obesity lead to improvements across the spectrum of psychological wellbeing in the short to medium term, including self-esteem and body image (current review), depression and anxiety (26/64 overlapping studies), 124 and eating disorders and eating disorder risk (16/64 overlapping studies) 125 following intervention. Reduced selfesteem and poor body image have a role in perpetuating further psychological pathology.…”

Section: Discussionmentioning

confidence: 74%

Pediatric obesity treatment, self‐esteem, and body image: A systematic review with meta‐analysis

et al. 2020

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Summary Background Pediatric obesity impacts on multiple domains of psychological health, including self‐esteem and body image. Objective To determine the effect of multicomponent pediatric obesity treatment interventions on self‐esteem and body image. Methods A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library, and PsychINFO. Eligible studies implemented an obesity treatment intervention, including a dietary and physical activity component with/without a behavioral component, in children and adolescents with overweight/obesity, and assessed self‐esteem and/or body image. Data were extracted by one reviewer and cross‐checked. Meta‐analysis was used to combine outcome data and moderator analysis conducted to identify intervention characteristics influencing outcomes. Results 64 studies were identified. Meta‐analysis of 49 studies (n = 10471) indicated that pediatric obesity treatment results in increased self‐esteem postintervention (standardized mean difference, [SE] 0.34 [0.03], P < .001, I2 87%), maintained at follow‐up (0.35 [0.05] P < .001, I2 79%, 17 studies). Similarly, meta‐analysis of 40 studies (n = 2729) indicated improvements in body image postintervention (0.40 [0.03], P < .001, I2 73%), maintained at follow‐up (0.41 [0.08], P < .001, I2 89%, 16 studies). Conclusions Pediatric obesity treatment improves self‐esteem and body image in the short and medium term. These findings may underpin improvements in other psychological outcomes.

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Section: Discussionmentioning

confidence: 74%

Pediatric obesity treatment, self‐esteem, and body image: A systematic review with meta‐analysis

et al. 2020

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“…Parents and clinicians have been concerned of inducing eating disorders later in childhood if the weight of the child is addressed to early 35 . However, this has not been corroborated 36 . Thus, in clinical practice, it has been discussed among paediatricians at what age overweight/obesity should be addressed as an issue when advising parents at the Child Health Centers.…”

Section: Discussionmentioning

confidence: 99%

Predicting the development of overweight and obesity in children between 2.5 and 8 years of age: The prospective ABIS study

Duchén

Jones

Faresjö

et al. 2020

Obesity Science & Practice

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Summary Background A relationship between overweight and obesity early in life and adolescence has been reported. The aim of this study was to track changes in overweight/obesity in children and to assess risk factors related to the persistence of overweight/obesity between 2.5 and 8 years. Study design Children who participated in all three follow‐ups at 2.5, 5 and 8 years in the prospective cohort All Children in Southeast Sweden (ABIS) (N = 2245, 52.1% boys and 47.9% girls) were classified as underweight, normal, overweight or with obesity, and changes within categories with age were related to risk factors for development of obesity in a multivariate analysis. Results The prevalence of overweight and obesity between 2.5 and 8 years was 11%–12% and 2%–3%, respectively. Children with normal weight remained in the same category over the years, 86% between 2.5 to 5 years and 87% between 5 and 8 years. Overweight and obesity at 5 and 8 years were positively related to each other (p < 0.0001 for both). High level of TV watching at 8 years and high maternal body mass index (BMI) when the child was 5 years were related to lower probability to a normalized ISO‐BMI between 5 and 8 years of age (p < 0.05 for both). Conclusion Children with ISO‐BMI 18.5 to 24.9 remain in that range during the first 8 years of life. Children with overweight early in life gain weight and develop obesity, and children with obesity tend to remain with obesity up to 8 years of age. TV watching and high maternal BMI were related to lower probability to weight normalization between 5 and 8 years of age. A multidisciplinary approach to promote dietary and physical activity changes in the entire family should be used for the treatment and prevention of overweight and obesity in early childhood.

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“…Others support the idea that new treatments are needed to address ED pathology and weight loss concurrently [ 40 ]. A recent systematic review and meta-analysis found that structured and professionally run obesity treatments are associated with reduced ED prevalence, risk, and symptoms in children [ 41 ]. However, because clinicians who work with patients with EDs often discover that the onset of disordered eating follows the first attempt to diet, many prefer a “do no harm” approach.…”

Section: Introductionmentioning

confidence: 99%

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

Wiss

Brewerton

2020

Nutrients

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Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction “diagnosis” among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or “the signal”) from the more classic eating pathology (true negatives, or “restraint”) that can potentially elevate food addiction scores (false positives, or “the noise”). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.

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Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta‐analysis

Cited by 105 publications

References 88 publications

Pediatric obesity treatment, self‐esteem, and body image: A systematic review with meta‐analysis

Pediatric obesity treatment, self‐esteem, and body image: A systematic review with meta‐analysis

Predicting the development of overweight and obesity in children between 2.5 and 8 years of age: The prospective ABIS study

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

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