Brief Primary Care Obesity Interventions: A Meta-analysis.

Area of Science:

• Pediatrics
• Public Health
• Evidence-Based Medicine

Background:

• Practice guidelines recommend BMI surveillance and counseling for children and adolescents.
• The evidence supporting these primary care interventions for pediatric weight management is unclear.

Purpose of the Study:

• To determine the effect of brief, primary care interventions for pediatric weight management on BMI.
• To assess the impact on body satisfaction.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies.
• Searched Medline, CENTRAL, Embase, PsycInfo, and CINAHL from January 1976 to March 2016.
• Extracted data on participant, intervention, study characteristics, BMI z scores, and harms.

Main Results:

• Brief primary care interventions were associated with a small but significant reduction in BMI z score (-0.04; P = .02).
• No significant effect was observed on body satisfaction (SMD 0.00; P = .98).
• Included 10 randomized controlled trials and 2 quasi-experimental studies.

Conclusions:

• BMI surveillance and counseling in primary care settings have a marginal effect on pediatric BMI.
• Methodological limitations and brief follow-up were noted in the included studies.
• Revised practice guidelines and novel approaches are needed for effective pediatric weight management.