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Cited by 1,531Obesity, Physical Activity, DietPharmacology and Obesity TreatmentBariatric Surgery and Outcomes

Interventions for treating obesity in children

Open access
Oude Luttikhuis, Hiltje, Baur, Louise, Jansen, Hanneke, Shrewsbury, Vanessa A, O'Malley, Claire, Stolk, Ronald P, Summerbell, Carolyn D·2009·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd001872.pub2
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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.

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  • Metformin may not be as effective as behavioral interventions in reducing BMI, and compared with drugs licensed for obesity, its effects are moderate.

    “Metformin may not be as effective as behavioral interventions in reducing BMI and when compared with drugs that are licensed for obesity, its effects are moderate [66].”

    From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [66]

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  1. resulting from physical training in obese children. American Journa of Clinical Nutrition 1999;69:705-711.

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Authors
Oude Luttikhuis, H., Baur, L., Jansen, H., Shrewsbury, V. A., O'Malley, C., Stolk, R. P., & Summerbell, C. D.
Affiliations
  • University Medical Center Groningen; Beatrix Children's Hospital and Department of Epidemiology; PO Box 30.001 (CA80) 9700RB Groningen Netherlands
  • The University of Sydney (AU)
  • University Medical Center Groningen (NL)
  • Wolfson Research Institute, Durham University ; School of Medicine and Health; Stockton-on-Tees UK TS17 6BH
  • Durham University (GB)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2009-01-20
Issue
1
Pages
CD001872-CD001872
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd001872.pub2
OpenAlex
W2119057053
Cited by
1,531
References
281
Citations by year
2026: 2 · 2025: 2 · 2024: 14 · 2023: 15 · 2022: 20 · 2021: 40 · 2020: 44 · 2019: 61 · 2018: 79 · 2017: 103 · 2016: 107 · 2015: 128 · 2014: 130 · 2013: 136 · 2012: 127
FWCI
21.54
Type
journal article
Language
en
Status
Retracted
Update notices
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, cc-by)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
  • Teesside University Research Portal (Teesside University) (submittedVersion, cc-by-nc-nd)
  • The Scientific Electronic Library Online (Fundação de Amparo à Pesquisa do Estado de São Paulo) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
childhood obesity, adolescent obesity, lifestyle intervention, behavior therapy, dietary intervention, physical activity, sedentary behavior, orlistat, sibutramine, metformin, bariatric surgery, weight loss
MeSH terms
Child, Diet, Reducing, Humans, Life Style, Motor Activity, Obesity, Randomized Controlled Trials as Topic, Anti-Obesity Agents

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