Abstract

Mühlig Y; Hebebrand J LVR-Klinikum Essen
Weight-loss treatment in children and adolescents: systematic review of potentials and limitations of behavioural lifestyle interventions

Yvonne Mühlig1, Johannes Hebebrand1
1Department of Child and Adolescent Psychiatry and Psychotherapy, LVR-Klinikum Essen, University Duisburg-Essen

Background: In Europe, prevalence rates for overweight and obesity in children and adolescents have plateaued at a high level. Due to the elevated risk of long-lasting somatic and psychiatric comorbidities, effective interventions to treat obesity are in frequent demand. Weight loss treatment has been shown to be effective, yet the overall outcome concerning weight status has not been sufficiently highlighted. The objectives of this review were a literature update and the deduction of clinical implications.
Methods: A systematic literature research was performed for studies published between May 2008 (terminating date of a 2009 Cochrane review) and December 2013 in the medical database Medline via PubMed. Studies were assessed on the basis of defined inclusion criteria and relevant criteria for methodological quality.
Results: 48 randomized controlled trials with a total of 5025 participants were identified and evaluated. With regard to eligible studies fulfilling predefined methodological quality criteria, weight losses between 0.05 and 0.42 BMI z-score within 24 months after starting conservative treatment were reported. 41 studies included data on dropout rates before the end of the intervention period. Dropout rates were 10% or higher in 27 studies (66%) and 25% or higher in 9 studies (22%).
Conclusion: Based on consistent evidence, treatment seeking children and adolescents and their families should be informed about the limited effect of conservative obesity treatment on weight status. The investigation of predictors for treatment success and the evaluation of additional treatments focusing on coping with obesity warrant future research.
Reference: Mühlig Y, Wabitsch M, Moss A, Hebebrand J. Weight loss in children and adolescents – a systematic review and evaluation of conservative, non-pharmacological obesity treatment programs. Dtsch Artzebl Int 2014; 111:818-24.

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