Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials

TLDR: Lifestyle interventions for pediatric overweight are efficacious in the short term with some evidence for extended persistence and future research is required to identify moderators and mediators and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status.

Abstract: Identifying and evaluating efficacious treatments for pediatric weight loss is of critical importance. This quantitative review represents the first meta-analysis of the efficacy of randomized controlled trials comparing lifestyle interventions to control conditions. MEDLINE, PsychINFO, and Cochrane Controlled Trials Register were searched up to August 2005. Eligible studies were randomized controlled trials involving lifestyle interventions for pediatric overweight that had as a comparison either a no-treatment or information/education-only control. The primary outcome of interest was change in weight status. Fourteen trials were eligible, resulting in 19 effect sizes. Information on study design, participant characteristics, interventions, and results were extracted using a standardized coding protocol. For trials with no-treatment controls, the mean effect size was 0.75 at end of treatment and 0.60 at follow-up. For trials with information/education only controls, the mean effect size was 0.48 at end of treatment and 0.91 at follow-up. No significant moderator effects were identified. Overall, lifestyle interventions for the treatment of pediatric overweight are efficacious in the short-term with some evidence for persistence of effects. Future research is required to identify moderators and mediators of outcome and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status.