Interventions for treating obesity in children

Hdl Handle:
http://hdl.handle.net/10149/58226
Title:
Interventions for treating obesity in children
Authors:
Luttikhuis, H. O. (Hiltje); Baur, L. (Louise); Jansen, H. (Hanneke); Shrewsbury, V. A. (Vanessa); O'Malley, C. (Claire); Stolk, R. P. (Ronald); Summerbell, C. D. (Carolyn)
Affiliation:
University Medical Center Groningen. Beatrix Children's Hospital and Department of Epidemiology. Netherlands; The University of Sydney. Department of Paediatrics and Child Health; University Medical Center Groningen. Department of Epidemiology. Netherlands; Durham University. Wolfson Research Institute. School of Medicine and Health.
Citation:
Luttikhuis, H. O. et al. (2009) 'Interventions for treating obesity in children', Cochrane Database of Systematic Reviews, 3, pp.1-57.
Publisher:
Wiley-Blackwell
Journal:
Cochrane Database of Systematic Reviews
Issue Date:
2009
URI:
http://hdl.handle.net/10149/58226
DOI:
10.1002/14651858.CD001872
Abstract:
Background: Child and adolescent obesity is increasingly prevalent, and can be associated with significant short- and long-term health consequences. Objectives: To assess the efficacy of lifestyle, drug and surgical interventions for treating obesity in childhood. Search strategy: We searched CENTRAL on The Cochrane Library Issue 2 2008, MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, DARE and NHS EED. Searches were undertaken from 1985 to May 2008. References were checked. No language restrictions were applied. Selection criteria: We selected randomised controlled trials (RCTs) of lifestyle (i.e. dietary, physical activity and/or behavioural therapy), drug and surgical interventions for treating obesity in children (mean age under 18 years) with or without the support of family members, with a minimum of six months follow up (three months for actual drug therapy). Interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity were excluded. Data collection and analysis: Two reviewers independently assessed trial quality and extracted data following the Cochrane Handbook. Where necessary authors were contacted for additional information. Main results: We included 64 RCTs (5230 participants). Lifestyle interventions focused on physical activity and sedentary behaviour in 12 studies, diet in 6 studies, and 36 concentrated on behaviorally orientated treatment programs. Three types of drug interventions (metformin, orlistat and sibutramine) were found in 10 studies. No surgical intervention was eligible for inclusion. The studies included varied greatly in intervention design, outcome measurements and methodological quality. Meta-analyses indicated a reduction in overweight at 6 and 12 months follow up in: i) lifestyle interventions involving children; and ii) lifestyle interventions in adolescents with or without the addition of orlistat or sibutramine. A range of adverse effects was noted in drug RCTs. Authors' conclusions: While there is limited quality data to recommend one treatment program to be favoured over another, this review shows that combined behavioural lifestyle interventions compared to standard care or self-help can produce a significant and clinically meaningful reduction in overweight in children and adolescents. In obese adolescents, consideration should be given to the use of either orlistat or sibutramine, as an adjunct to lifestyle interventions, although this approach needs to be carefully weighed up against the potential for adverse effects. Furthermore, high quality research that considers psychosocial determinants for behaviour change, strategies to improve clinician-family interaction, and cost-effective programs for primary and community care is required.
Type:
Article
Keywords:
obesity; interventions; children; adolescents
ISSN:
1464-780X
Rights:
In return for the grant of the licence, the author(s) shall have the following rights: The right to post the review as an electronic file on the the author's own website and/or the author's institution's website, using the PDF version of the review available in the Cochrane Database of Systematic Reviews. [Advice from CEO of The Cochane Collaboration]
Citation Count:
5 [Scopus (print and online) 14/01/2010]

Full metadata record

DC FieldValue Language
dc.contributor.authorLuttikhuis, H. O. (Hiltje)-
dc.contributor.authorBaur, L. (Louise)-
dc.contributor.authorJansen, H. (Hanneke)-
dc.contributor.authorShrewsbury, V. A. (Vanessa)-
dc.contributor.authorO'Malley, C. (Claire)-
dc.contributor.authorStolk, R. P. (Ronald)-
dc.contributor.authorSummerbell, C. D. (Carolyn)-
dc.date.accessioned2009-04-01T10:46:29Z-
dc.date.available2009-04-01T10:46:29Z-
dc.date.issued2009-
dc.identifier.citationCochrane Database of Systematic Reviews; 3: 1-57-
dc.identifier.issn1464-780X-
dc.identifier.doi10.1002/14651858.CD001872-
dc.identifier.urihttp://hdl.handle.net/10149/58226-
dc.description.abstractBackground: Child and adolescent obesity is increasingly prevalent, and can be associated with significant short- and long-term health consequences. Objectives: To assess the efficacy of lifestyle, drug and surgical interventions for treating obesity in childhood. Search strategy: We searched CENTRAL on The Cochrane Library Issue 2 2008, MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, DARE and NHS EED. Searches were undertaken from 1985 to May 2008. References were checked. No language restrictions were applied. Selection criteria: We selected randomised controlled trials (RCTs) of lifestyle (i.e. dietary, physical activity and/or behavioural therapy), drug and surgical interventions for treating obesity in children (mean age under 18 years) with or without the support of family members, with a minimum of six months follow up (three months for actual drug therapy). Interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity were excluded. Data collection and analysis: Two reviewers independently assessed trial quality and extracted data following the Cochrane Handbook. Where necessary authors were contacted for additional information. Main results: We included 64 RCTs (5230 participants). Lifestyle interventions focused on physical activity and sedentary behaviour in 12 studies, diet in 6 studies, and 36 concentrated on behaviorally orientated treatment programs. Three types of drug interventions (metformin, orlistat and sibutramine) were found in 10 studies. No surgical intervention was eligible for inclusion. The studies included varied greatly in intervention design, outcome measurements and methodological quality. Meta-analyses indicated a reduction in overweight at 6 and 12 months follow up in: i) lifestyle interventions involving children; and ii) lifestyle interventions in adolescents with or without the addition of orlistat or sibutramine. A range of adverse effects was noted in drug RCTs. Authors' conclusions: While there is limited quality data to recommend one treatment program to be favoured over another, this review shows that combined behavioural lifestyle interventions compared to standard care or self-help can produce a significant and clinically meaningful reduction in overweight in children and adolescents. In obese adolescents, consideration should be given to the use of either orlistat or sibutramine, as an adjunct to lifestyle interventions, although this approach needs to be carefully weighed up against the potential for adverse effects. Furthermore, high quality research that considers psychosocial determinants for behaviour change, strategies to improve clinician-family interaction, and cost-effective programs for primary and community care is required.-
dc.publisherWiley-Blackwell-
dc.rightsIn return for the grant of the licence, the author(s) shall have the following rights: The right to post the review as an electronic file on the the author's own website and/or the author's institution's website, using the PDF version of the review available in the Cochrane Database of Systematic Reviews. [Advice from CEO of The Cochane Collaboration]-
dc.subjectobesity-
dc.subjectinterventions-
dc.subjectchildren-
dc.subjectadolescents-
dc.titleInterventions for treating obesity in children-
dc.typeArticle-
dc.contributor.departmentUniversity Medical Center Groningen. Beatrix Children's Hospital and Department of Epidemiology. Netherlands; The University of Sydney. Department of Paediatrics and Child Health; University Medical Center Groningen. Department of Epidemiology. Netherlands; Durham University. Wolfson Research Institute. School of Medicine and Health.-
dc.identifier.journalCochrane Database of Systematic Reviews-
ref.assessmentRAE 2008-
ref.citationcount5 [Scopus (print and online) 14/01/2010]-
or.citation.harvardLuttikhuis, H. O. et al. (2009) 'Interventions for treating obesity in children', Cochrane Database of Systematic Reviews, 3, pp.1-57.-
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