Cognitive Behavioral Interventions for Children and Adolescents With Overweight or Obesity: A Systematic Review and...

Area of Science:

• Pediatric Endocrinology
• Behavioral Medicine
• Public Health

Background:

• The effectiveness of individual components within cognitive behavioral therapy (CBT) for pediatric obesity management is not well-established.
• This systematic evaluation investigates the impact of CBT and its specific techniques on children and adolescents with obesity.

Purpose of the Study:

• To systematically evaluate the efficacy of cognitive behavioral therapy (CBT) components for pediatric obesity.
• To compare the effects of different CBT techniques against usual care or minimal education in managing childhood obesity.

Main Methods:

• A systematic search of PubMed, Embase, and Cochrane CENTRAL was conducted up to July 17, 2024.
• Included randomized controlled trials (RCTs) comparing CBT techniques for obesity management in pediatric populations.
• Component network meta-analyses and modified GRADE approaches were used to assess evidence certainty and effect sizes.

Main Results:

• 125 trials involving 16,513 participants were analyzed.
• Behavioral therapy likely reduces body fat percentage, waist circumference, and improves quality of life.
• Parental involvement and stimulus control probably reduce BMI z-score; preplanning and feedback likely reduce body fat percentage.

Conclusions:

• Behavioral therapy, independent of cognitive components, appears effective for pediatric obesity.
• Key CBT techniques for prioritization include parental involvement, stimulus control, preplanning, and feedback for optimal results.