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

Abstract

Context: Evaluating the efficacy of pediatric weight loss treatments is critical.

Objective: This is the first meta-analysis of the efficacy of RCTs comparing pediatric lifestyle interventions to no-treatment or information/education-only controls.

Data sources: Medline, PsycINFO, and Cochrane Controlled Trials Register.

Study selection: Fourteen RCTs targetting change in weight status were eligible, yielding 19 effect sizes.

Data extraction: Standardized coding was used to extract information on design, participant characteristics, interventions, and results.

Data synthesis: For trials with no-treatment controls, the mean effect size was 0.75 (k = 9, 95% confidence interval [CI] = 0.52-0.98) at end of treatment and 0.60 (k = 4, CI = 0.27-0.94) at follow-up. For trials with information/education-only controls, the mean ES was 0.48 (k = 4, CI = 0.13-0.82) at end of treatment and 0.91 (k = 2, CI = 0.32-1.50) at follow-up. No moderator effects were identified.

Conclusions: Lifestyle interventions for pediatric overweight are efficacious in the short term with some evidence for extended persistence. 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.

(PsycINFO Database Record (c) 2007 APA, all rights reserved).

Figures

Figure 1

Flow of studies into the review of randomized controlled trials of the effectiveness of lifestyle interventions for pediatric overweight.

Figure 2

Study-specific and weighted mean effect sizes and confidence intervals, categorized by comparison group.

Figure 3

Effect sizes plotted by time, showing an increasing trend for treatment time points and a decreasing trend for follow-up time points.