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Cited by 70Obesity, Physical Activity, DietEating Disorders and BehaviorsChild and Adolescent Psychosocial and Emotional Development

Association of Pediatric Obesity Treatment, Including a Dietary Component, With Change in Depression and Anxiety: A Systematic Review and Meta-analysis

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Jebeile, Hiba, Gow, Megan L., Baur, Louise A., Garnett, Sarah P., Paxton, Susan J., Lister, Natalie B.·2019·JAMA Pediatrics
DOI 10.1001/jamapediatrics.2019.2841PMC PMC6749546
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Abstract

IMPORTANCE: Children and adolescents with obesity are at higher risk of developing depression and anxiety, and adolescent dieting is a risk factor for the development of depression. Therefore, determining the psychological effect of obesity treatment interventions is important to consider. OBJECTIVE: To investigate the association between obesity treatment interventions, with a dietary component, and the change in symptoms of depression and anxiety in children and adolescents with overweight/obesity. DATA SOURCES: Searches of MEDLINE, Embase, Cochrane Library, and PsychINFO were conducted from inception to August 2018. Hand searching of references was conducted to identify missing studies. STUDY SELECTION: Obesity treatment interventions, with a dietary component, conducted in children and adolescents (age <18 years) with overweight/obesity, and validated assessment of depression and/or anxiety were included. DATA EXTRACTION AND SYNTHESIS: Data were independently extracted by 1 reviewer and checked for accuracy. Meta-analysis, using a random-effects model, was used to combine outcome data and moderator analysis conducted to identify intervention characteristics that may influence change in depression and anxiety. The meta-analyses were finalized in May 2019. MAIN OUTCOMES AND MEASURES: Change in symptoms of depression and anxiety postintervention and at the latest follow-up. RESULTS: Of 3078 articles screened, 44 studies met inclusion criteria with a combined sample of 3702 participants (age range, 5.6 to 16.6 years) and intervention duration of 2 weeks to 15 months. Studies reported either no change or a statistically significant reduction in symptoms of depression or anxiety. Meta-analyses of 36 studies found a reduction in depressive symptoms postintervention (standardized mean difference [SE], -0.31 [0.04]; P < .001), maintained at follow-up in 11 studies at 6 to 16 months from baseline (standardized mean difference [SE], -0.25 [0.07]; P < .001). Anxiety was reduced postintervention (10 studies; standardized mean difference [SE], -0.38 [0.10]; P < .001) and at follow-up (4 studies; standardized mean difference [SE], -0.32 [0.15]; P = .03). Longer intervention duration was associated with a greater reduction in anxiety (R2 = 0.82; P < .001). Higher body mass index z score at baseline was associated with a greater reduction in depression (R2 = 0.19; P = .03). CONCLUSIONS AND RELEVANCE: Structured, professionally run pediatric obesity treatment is not associated with an increased risk of depression or anxiety and may result in a mild reduction in symptoms. Treatment of weight concerns should be considered within the treatment plan for young people with depression and obesity.

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  • Metabolic diseases and obesity may adversely impact mental health.

    “which themselves may adversely impact mental health 121-123”

    From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [122]

    The Abstract (page unavailable) reports poorer psychological well-being and higher rates of depression and anxiety among children and adolescents with obesity than among peers with healthy weight. This supports the obesity portion of the claim, but the paper does not establish the same point for metabolic diseases generally or for populations beyond children and adolescents. (LLM, conf=0.85)

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  • Later consequences of a poor diet include obesity and diabetes, which have already been shown to be associated with poorer mental health.

    “For example, the later consequences of a poor diet include obesity and diabetes, which have already been shown to be associated with poorer mental health.11 31 32 33”

    From Food and mood: How do diet and nutrition affect mental wellbeing? (2020) · cites this paper as [32]

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10 of the 99 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. Jacobson D. A Primary Care School age Healthy Choices Intervention Program [dissertation]. Tempe: Arizona State University; 2009.
  2. Ampolos L. The Role of Nutritional Intake in Weight and Depressive Symptomatology on Children Participating in Family-Based Therapy for Weight Reduction [dissertation]. San Diego: Alliant International University; 2012.
  3. Reynolds CR, Kamphaus RW. Behavior Assessment System for Children, (BASC-2) Handout. Circle Pines, MN: AGS Publishing; 2004:55014-51796.
  4. Hien D, Matzner F, First M, Spitzer R, Gibbon M, Williams J. Structured clinical interview for DSM-IV-child edition (version 1.0). New York, NY: Columbia University; 1994.
  5. Spielberger C. Manual for the State-Trait Anxiety Inventory (Self-Evaluation Questionnare). Palo Alto, CA: Consulting Psychogyists Press; 1970.
  6. Spielberger CD, Edwards CD. STAIC Preliminary Manual for the State-Trait Anxiety Inventory for Children ("How I Feel Questionnaire"). Palo Alto, CA: Consulting Psychologists Press; 1973.

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Authors
Jebeile, H., Gow, M. L., Baur, L. A., Garnett, S. P., Paxton, S. J., & Lister, N. B.
Affiliations
  • The University of Sydney (AU)
  • La Trobe University (AU)
Corresponding author
Jebeile, Hiba
ORCID
Venue
JAMA Pediatrics
Publisher
American Medical Association (AMA)
Published
2019-11-04
Volume
173
Issue
11
Pages
e192841
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
DOI
10.1001/jamapediatrics.2019.2841
PMC
PMC6749546
OpenAlex
W2974565622
Cited by
70
References
99
Citations by year
2026: 5 · 2025: 8 · 2024: 7 · 2023: 10 · 2022: 7 · 2021: 17 · 2020: 13 · 2019: 2
FWCI
8.98
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
childhood obesity, adolescent obesity, overweight, dietary intervention, depression, anxiety, depressive symptoms, anxiety symptoms, psychological outcomes, intervention duration, BMI z-score, children, weight loss interventions, follow-up outcomes, treatment moderators

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