The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta-analysis.

Patricia Eustachio Colombo, Milindu Wickramarachchi, Aiswarya Lakshmi, Laura Kudlek, Amy Ahern, Struan Tait, Natasha Reid, Rebecca A Jones, Andrea D Smith

Journal: Obesity reviews : an official journal of the International Association for the Study of Obesity 2024;26(1):e13839

PMID: 39299797

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Plain Language Summary

Childhood obesity is challenging to reverse, tracks into adolescence and adulthood, and the negative health effects follow into adulthood also. The high prevalence of childhood obesity and negative associated consequences highlights the need for effective weight management treatments. Behavioural weight management interventions (BWMIs) addressing diet, physical activity, and lifestyle habits are key treatments for childhood and adolescent obesity. This study aimed to assess the impact of child BWMIs on eating behaviour traits (EBTs) compared to the usual care, inactive, or minimal intervention group. This research was a systematic review with narrative synthesis and meta-analysis of randomised controlled trials of eight articles with a total of 11,384 participants (children living with overweight or obesity). Results showed that paediatric BWMIs resulted in positive short-term effects on dietary restraint at programme completion. Additionally, the interventions resulted in positive improvements in children's emotional eating, external eating, food responsiveness, and enjoyment of food. However, these improvements were predominantly observed at the end of the intervention, with effects no longer significant at later follow-up. Authors concluded that BWMIs are beneficial for the improvement of some EBTs at intervention end, including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food.

Abstract

INTRODUCTION

Behavioral weight management interventions (BWMIs) are an evidence-based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study describes a systematic review and meta-analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity.

METHODS

Seven databases were searched, and eligible studies included randomized controlled trials reporting EBT outcomes following BWMIs delivered to children with overweight or obesity (<18 years of age). Random effects meta-analyses were conducted to compare EBT outcomes for intervention and control groups. Synthesis without meta-analysis (SWiM) was applied for EBTs where meta-analysis was not feasible.

RESULTS

The review identified eight trials characterizing the impact of BWMIs on 15 EBTs. Meta-analyses of data from three trials at intervention completion and post-intervention (average of 28 weeks [±8]) revealed positive short-term increases in dietary restraint (SMD random effect 0.42 [95% CI 0.13, 0.70]). However, these effects were not sustained at follow-up. Improvements in emotional eating, external eating, food responsiveness, and enjoyment of food were shown in studies which could not be pooled quantitatively.

CONCLUSION

BWMIs in children living with overweight/obesity are beneficial for the improvement of some EBTs at intervention completion including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food. However, this remains a relatively unexplored area and more research is needed to strengthen understanding of the multifaceted impact of child BWMIs on a comprehensive range of EBTs.

Address: School of Clinical Medicine, University of Cambridge, Cambridge, UK.; Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK.; MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.

DOI: 10.1111/obr.13839