Maintenance interventions for overweight or obesity in children: a systematic review and meta‐analysis

Abstract

Childhood obesity is associated with significant health consequences. Although several intervention programmes for children result in weight loss or stabilization in the short-term, preventing relapse after treatment remains an important challenge. This systematic review summarizes the evidence about maintenance interventions after treatment in childhood obesity. Studies were identified by searching PubMed, Embase, Cochrane Library, Scopus, Web of Science, PsycINFO, CINAHL and SocINDEX. The primary outcome measure for this review was body mass index standard deviation score (BMI-Z-score). Data were pooled using quality effect models. Eleven studies (1,532 participants, age 2-18 years) were included, covering a wide range of maintenance approaches. Included studies varied widely in methodological quality. Pooled analysis showed that the BMI-Z-score of maintenance intervention participants remained stable, whereas control participants experienced a slight increase. No differences were observed regarding intensity and duration of therapy. A slight preference for 'face-to-face' versus 'on distance' interventions was shown.In summary, this review shows that, although there is limited quality data to recommend one maintenance intervention over another, continued treatment does have a stabilizing effect on BMI-Z-score. Considering the magnitude of the problem of childhood obesity, this is an important finding that highlights the need for further research on weight loss maintenance.

Aim2Be mHealth intervention for children with overweight and obesity: study protocol for a randomized controlled trial

“…It retained its focus on linking behaviors with health and living green, as well as adding emphasis on healthy body image and strong self-esteem. While Aim2Be retained some core elements from the LiGHT program, it 1) became strongly grounded in theories of behavior change (i.e., being family-based, supporting the development of self-regulatory skills at both the individual and familial levels, and enhancing self-efficacy through graded tasks) [10,11,19,33]; 2) integrated principles of maintenance of health behaviors and as such it included selfregulatory processes that support intrinsic motivation [34][35][36][37][38]; 3) integrated gamification practices, which are designed to maximize both enjoyment and motivation [39]; 4) recognized the importance of body image and selfconfidence in lifestyle management; 5) used the mHealth context to support self-regulatory processes [40]; 6) aligned with best clinical practices and guidelines in three areas (including a) the treatment of childhood obesity in Canada as it aligns with the curriculum of Canadian Weight Management programs (e.g., being family based, multi-behavioral, and focused on supporting skill development at the individual and familial levels); b) clinical guidelines for the management of childhood obesity as it integrates the central elements that need to be incorporated in these interventions (e.g., family focused, focused on improving lifestyle behaviors, skill based support) [41]; and c) Canadian health recommendations including the Canadian 24 Hour Movement Guidelines [42] and Canada's Food Guide [43]); and 7) was designed specifically with and for children and their families (see details below).…”

Efecto clínico y metabólico de una intervención multidisciplinaria en el marco de un programa de atención integral para niños y adolescentes con obesidad

“…En estudios recientes, se destaca la importancia de un mayor seguimiento en los programas de obesidad infantil, tal como lo evidencia el metaanálisis publicado por van Der Heijden, et al 21 , en el que se plantea que el tratamiento continuado tiene un efecto estabilizador en el puntaje Z del IMC. Considerando la magnitud del problema de la obesidad infantil, este hallazgo resalta la necesidad de implementar estrategias de mantenimiento de la mejoría del IMC 21 . Además de los cambios antropométricos, se debería tener en cuenta la composición corporal para conocer con precisión las variaciones en el porcentaje de masa grasa y masa magra 64 .…”

“…En numerosos estudios se ha evaluado la efectividad de los programas multidisciplinarios con apoyo familiar para tratar el sobrepeso y la obesidad infantil 11 , 15 , 18 - 20 . Sin embargo, la obesidad es una enfermedad crónica y mantener el índice de masa corporal (IMC) esperado para la edad después de una pérdida de peso inicial o de su estabilización representa el principal desafío 19 , 21 .…”

Aim2Be an mHealth intervention for children with overweight and obesity: Study protocol for a randomized controlled trial

“…supporting the development of self-regulatory skills at both the individual and familial levels; and enhancing self-efficacy through graded tasks) (10,11,19,33); 2) integrated principles of maintenance of health behaviours and as such it included self-regulatory processes that support intrinsic motivation (34)(35)(36)(37)(38); 3) integrated gamification practices -designed to maximize for both enjoyment and motivation (39); 4) recognized the importance of body image and self-confidence in lifestyle management, 5) used the mHealth context to support self-regulatory processes (40); 6) aligned with best clinical practices and guidelines in three areas: a) the treatment of childhood obesity in Canada as it aligns with the curriculum of Canadian Weight Management programs (e.g., being family based, multi-behavioural, and focus on supporting skill development at the individual and familial levels); b) clinical guidelines for the management of childhood obesity as it integrates the central elements that need to be incorporated in these interventions (e.g., family focused, focused on improving lifestyle behaviours, skill based support) (41); and c) Canadian health recommendations including the Canadian 24 Hour Movement Guidelines (42) and Canada's Food Guide (43); and 7) was designed specifically with and for children and their families (see details below).…”