ESPEYB15 15 Editor’s Choice Interventions for overweight and obesity do work (1 abstracts)
15.3 Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years
Mead E , Brown T , Rees K , Azevedo LB , Whittaker V , Jones D , Olajide J , Mainardi GM , Corpeleijn E , O'Malley C , Beardsmore E , Al-Khudairy L , Baur L , Metzendorf MI , Demaio A & Ells LJ
Health and Social Care Institute, Teesside University, Middlesbrough, UK
To read the full abstract: Cochrane Database Syst Rev 2017;6:CD012651
Here, the authors report an update of a Cochrane review, which was first published in 2003, and last updated in 2009. However, given the complexity of the evidence, the current update is now split into 6 reviews addressing different childhood obesity treatments at different ages. The bottom line is that multi-component behaviour-changing interventions are effective in reducing weight and BMI, and are safe, with very low occurrence of adverse events. An accompanying report shows similar positive findings in overweight or obese adolescents aged 12-17 years (1). Several limitations were highlighted, including the low or very low quality of the evidence and high risk of bias, and heterogeneity between RCTs that could not be explained, and there remains the question over sustainability of the BMI reductions over the longer term. It is important to acknowledge those limitations, the need for more evidence regarding the most effective and cost-effective approaches, and how these individual-level behaviour change approaches might integrate with wider policy and systems level changes, e.g. to change food composition, advertising and infrastructure to promote physical activity. But meanwhile, it is untrue to say that we do not know what to do to reduce weight and BMI in overweight and obese children – such arguments sometimes hamper efforts to screen for childhood obesity, or are used by some health practitioners to defend not raising the issue as an incidental finding in the clinic.
1. Al-Khudairy L, Loveman E, Colquitt JL, Mead E, Johnson RE, Fraser H, Olajide J, Murphy M, Velho RM, O’Malley C, Azevedo LB, Ells LJ, Metzendorf MI, Rees K. Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years. Cochrane Database Syst Rev 2017;6:CD012691.
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ESPE Yearbook of Paediatric Endocrinology
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