Effect of lifestyle interventions on pediatric obesity: a lifestyle medicine systematic review

Childhood and adolescent obesity are major public health concerns with adverse cardiometabolic outcomes. Lifestyle interventions are the cornerstone of management; however, their effects are often evaluated as single components rather than being within an integrated framework. Lifestyle medicine recently emerged as a comprehensive approach emphasizing multiple health behaviors. This study aimed to evaluate the effects of lifestyle interventions on anthropometric and cardiometabolic outcomes in children and adolescents with overweight or obesity and interpret these findings within the framework of lifestyle medicine. A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) 2020 guidelines. PubMed and Web of Science were searched for studies published from January 2019 to March 2026. Eligible studies examined children and adolescents with overweight or obesity who were receiving lifestyle interventions, including physical activity, dietary modification, or multicomponent approaches. The primary outcomes were anthropometric measures, while the secondary outcomes were cardiometabolic parameters. Sixteen studies were ultimately included. Lifestyle interventions were associated with improvements in anthropometric and cardiometabolic outcomes. All 5 exercise-based intervention studies reported improved anthropometric or cardiometabolic outcomes, particularly following high-intensity interval training. Among the 8 dietary intervention studies, 7 reported significant improvements, whereas one found no significant intergroup differences. All 3 multicomponent lifestyle intervention studies demonstrated favorable anthropometric and cardiometabolic outcomes. This analysis demonstrates that lifestyle interventions effectively treat pediatric obesity, with multicomponent approaches showing the greatest benefit. These findings support the importance of integrated lifestyle strategies consistent with lifestyle medicine principles. Further long-term studies are needed to confirm these findings.