Behavior-change lifestyle interventions for the treatment of obesity in children and adolescents: A scoping review

Abstract

Behavior-change lifestyle interventions are fundamental in children and adolescent obesity management. This scoping review discusses optimal behavior-change lifestyle interventions in the treatment of overweight and obesity in children and adolescents. A literature search on diet, physical activity, and behavioral intervention for obesity treatment in children and adolescents aged 0–19 years was conducted in the Cochrane Library, MEDLINE (OVID), EMBASE, and ClinicalTrials.gov. Systematic reviews and meta-analyses with randomized controlled trials (RCTs) published in English from June 2016 to November 2022 were retrieved to identify recent advancements. Obesity outcomes included body weight, body mass index (BMI), BMI z-score, and fat percentage, among others. The 28 located reviews included: four studies on diet therapy; five on physical activity (exercise training); one on sedentary activities; 18 on multicomponent behavior-change lifestyle interventions, including three that incorporated gaming; three with eHealth, mobile health (mHealth), or telehealth, with one in each category; and two on motivational interviewing. Behavior-change lifestyle interventions to reduce obesity in children and adolescents were associated with moderate effects, with low-quality evidence for diet therapy and high-quality evidence for exercise training, both for weight or BMI reduction. Long-term intensive multicomponent behavioral interventions with parental involvement demonstrated better effects.