OBJECTIVES:To examine the benefits and harms of behavioral and pharmacologic weight-management interventions for overweight and obese children and adolescents. METHODS:Our data sources were Ovid Medline, PsycINFO, the Education Resources Information Center, the Database of Abstracts of Reviews of Effects, the Cochrane databases, reference lists of other reviews and trials, and expert recommendations. After 2 investigators reviewed 2786 abstracts and 369 articles against inclusion/exclusion criteria, we included 15 fair-to good-quality trials in which the effects of treatment on weight, weight-related comorbidities, and harms were evaluated. Studies were quality rated by 2 investigators using established criteria. Investigators abstracted data into standard evidence tables. RESULTS:In the available research, obese (or overweight) children and adolescents aged 4 to 18 years were enrolled, and no studies targeted those younger than 4 years. Comprehensive behavioral interventions of medium-to-high intensity were the most effective behavioral approach with 1.9 to 3.3 kg/m 2 difference favoring intervention groups at 12 months. More limited evidence suggests that these improvements can be maintained over the 12 months after the end of treatments and that there are few harms with behavioral interventions. Two medications combined with behavioral interventions resulted in small (0.85 kg/m 2 for orlistat) or moderate (2.6 kg/m 2 for sibutramine) BMI reduction in obese adolescents on active medication; however, no studies followed weight changes after medication use ended. Potential adverse effects were greater than for behavioral interventions alone and varied in severity. Only 1 medication (orlistat) has been approved by the US Food and Drug Administration for prescription use in those aged Ն12 years. CONCLUSIONS:Over the past several years, research into weight management in obese children and adolescents has improved in quality and quantity. Despite important gaps, available research supports at least short-term benefits of comprehensive medium-to high-intensity behavioral interventions in obese children and adolescents. Pediatrics 2010;125:e396-e418 In 2005, the US Preventive Services Task Force (USPSTF) found insufficient evidence to recommend for or against routine primary care screening for overweight in children and adolescents as a means of preventing adverse health outcomes (an "I" recommendation). 1,2 The USPSTF concluded that, although there was fair evidence that overweight adolescents and children aged Ն8 years are at increased risk for becoming obese adults, the efficacy of behavioral counseling or other primary care-relevant interventions for treating overweight children and adolescents was uncertain.Given the findings in a recently published systematic review on weightmanagement programs for children and adolescents, 3 the USPSTF decided to update its recommendation, focusing on the critical evidence gap concerning treatment efficacy at the time of the last review. Thus, for this targeted systematic revi...

Agency for Healthcare Research and Quality.

Daily low-dose aspirin beginning as early as the second trimester prevented clinically important health outcomes. No harms were identified, but long-term evidence was limited.

A brief, group cognitive therapy prevention program can reduce the risk for depression in the adolescent offspring of parents with a history of depression.

IMPORTANCE Overweight and obesity have been associated with adverse health effects. OBJECTIVE To systematically review evidence on benefits and harms of behavioral and pharmacotherapy weight loss and weight loss maintenance interventions in adults to inform the US Preventive Services Task Force.