Cochrane review: Interventions for treating obesity in children
Identifieur interne : 000314 ( Main/Exploration ); précédent : 000313; suivant : 000315Cochrane review: Interventions for treating obesity in children
Auteurs : Hiltje Oude Luttikhuis [Pays-Bas] ; Louise Baur [Australie] ; Hanneke Jansen [Pays-Bas] ; Vanessa A. Shrewsbury [Australie] ; Claire O'Malley [Royaume-Uni] ; Ronald P. Stolk [Pays-Bas] ; Carolyn D. Summerbell [Royaume-Uni]Source :
- Evidence‐Based Child Health: A Cochrane Review Journal [ 1557-6272 ] ; 2009-12.
English descriptors
- Teeft :
- Acta, Adipose, Adiposity, Adj2, Adj3, Adolescen, Adolescent, Adolescent obesity, Adverse effects, Adverse events, Aerobic, Aerobic exercise, Allocation, Alternative intervention, American journal, Analysis comparison, Assessor, Balagopal, Balanced diet, Bariatric, Bariatric surgery, Baseline, Baur, Behavio, Behavior change, Behavior therapy, Behavioral, Behavioral component, Behaviour, Behaviour change, Behaviour changes, Behavioural, Behavioural component, Behavioural intervention, Behavioural program, Behavioural therapy, Berkowitz, Bias item authors, Biweekly, Blinding, Blood pressure, Body composition, Body mass index, Body weight, Braet, Caloric intake, Calorie, Carbohydrate, Cardiovascular, Centile, Chang, Chanoine, Chi2, Child behavioural, Child health, Child protection, Child unit, Childhood obesity, Children comparison, Clear drop outs, Clinic, Clinical trial, Cochrane, Cochrane collaboration, Cochrane handbook, Cognitive, Cohort, Collaboration, Colour, Concealment, Contamination, Control condition, Control group, Control group target, Conventional treatment, Copyright, Counselling, Database, Deforche, Depressant, Diastolic, Dietary, Dietary intake, Dietetic, Dietician, Dieting, Dietitian, Dietz, Difference weight, Dissertation, Doubl, Drop outs, Dropout, Drug interventions, Drug trials, Ebbeling, Effect size, Eliakim, Endocrinology, Energy intake, Epstein, Exercise plan, Exercise therapy, Experimental group, Extent parents, Family behavioural, Family members, Family therapy, Fasting, Fatness, Flodmark, Followup, Food guide pyramid, Food intake, Food pyramid, Freemark, Gastric, Gender weight, Geographic region, Glenny, Glucose, Golan, Golley, Graf, Green foods, Groningen, Group sessions, Group therapy, Guideline, Gutin, Health education, Health promotion, Health status, Heart rate, Height weight, Heterogeneity, Higgins, Homework, Hyperphagia, Hypocaloric, Individual child family, Individual child protection, Individual child unit, Inpatient, International journal, Intervention, Intervention group, Intervention group control group, Interventions intervention, Interventions interventions, Janicke, Jelalian, Jiang, John wiley sons, Judgement, Judgement description allocation concealment, Kalavainen, Kcal, Laparoscopic, Life style, Lifestyle, Lifestyle changes, Lifestyle intervention, Lifestyle interventions, Lifestyle studies, Light diet, Lipid, Litaker, Lobstein, Maahs, Mccallum, Medication, Medline, Metformin, Modelling, Modif, Monthly meetings, Months unit, Morbidly, Munsch, Ndings, Near2, Notes risk, Nova, Nutrional, Nutrional advice, Nutrition, Nutritional, Nutritional advice, Obese, Obese adolescents, Obese children, Obesity, Obesity treatment, Older outcome, Orlistat, Outcome assessors, Outcome data, Outcomes height, Outcomes weight status, Outpatient, Outpatient clinic, Overall effect, Overweight, Overweight adolescents, Overweight children, Ozkan, Paediatr, Paediatric, Paediatrica, Paediatrician, Paluch, Parent, Parent behavioural, Parenting, Participant, Participants views, Pediatr, Pediatric, Pediatric obesity, Pediatrics, Pedometer, Percentile, Physical activities, Physical activity, Physical education, Physical therapy, Physical training, Physical work capacity, Placebo, Placebo group, Polic, Ponderal, Ponderal index, Predictor, Preventative, Primary prevention, Programme, Prot, Provider, Psychological component, Psychosocial, Pulse rate, Randomi, Randomisation, Randomisation process, Randomisation process interventions, Randomised, Randomized, Rcts, Regular meals, Reinehr, Reinforcement, Reinforcer, Rodearmel, Roemmich, Saelens, Same cohort, Same study, Savoye, School children, Schoolchildren, Schwingshandl, Sedentary, Sedentary activities, Sedentary behaviours, Self esteem, Sibutramine, Sibutramine capsules, Sibutramine group, Singl, Skills training, Skinfold, Social support, Srinivasan, Standard care, Stimulus control, Strateg, Study arms, Study design, Subgroup, Subgroup behavioural group intervention, Subheading, Summerbell, Suppressant, Surgical, Surgical intervention, Surgical interventions, Systematic review, Systolic, Therap, Therapy, Tness, Topical subheadings, Total cholesterol, Treatment meetings, Treatment period, Treatment phase, Treatment program, Treatment session, Treatment sessions, Trebl, Triceps, Triglyceride, Tripl, Unclear, Unclear drop outs, Unclear length, Unclear outcome assessors, Unclear providers, Usual care, Wadden, Waist circumference, Wang, Warschburger, Week period, Weekly sessions, Weeks treatment, Weight change, Weight control, Weight entry criteria, Weight gain, Weight loss, Weight management program, Weight reduction, Weintraub, Wiley, Williamson, Workbook, Years years, Young adult, Young people, Young person.
Abstract
Child and adolescent obesity is increasingly prevalent, and can be associated with significant short‐ and long‐term health consequences.
To assess the efficacy of lifestyle, drug and surgical interventions for treating obesity in childhood.
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.
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.
Two reviewers independently assessed trial quality and extracted data following the Cochrane Handbook. Where necessary authors were contacted for additional information.
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.
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.
Treating obesity in children Childhood obesity affects both the physical and psychosocial health of children and may put them at risk of ill health as adults. More information is needed about the best way to treat obesity in children and adolescents. In this review, 64 studies were examined including 54 studies on lifestyle treatments (with a focus on diet, physical activity or behaviour change) and 10 studies on drug treatment to help overweight and obese children and their families with weight control. No surgical treatment studies were suitable to include in this review. This review showed that lifestyle programs can reduce the level of overweight in child and adolescent obesity 6 and 12 months after the beginning of the program. In moderate to severely obese adolescents, a reduction in overweight was found when either the drug orlistat, or the drug sibutramine were given in addition to a lifestyle program, although a range of adverse effects was also noted. Information on the long‐term outcome of obesity treatment in children and adolescents was limited and needs to be examined in some high quality studies.
Url:
DOI: 10.1002/ebch.462
Affiliations:
- Australie, Pays-Bas, Royaume-Uni
- Groningue (province), Nouvelle-Galles du Sud
- Groningue, Sydney
- Université de Sydney
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type="abstract">Child and adolescent obesity is increasingly prevalent, and can be associated with significant short‐ and long‐term health consequences.</div><div type="abstract">To assess the efficacy of lifestyle, drug and surgical interventions for treating obesity in childhood.</div><div type="abstract">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.</div><div type="abstract">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.</div><div type="abstract">Two reviewers independently assessed trial quality and extracted data following the Cochrane Handbook. Where necessary authors were contacted for additional information.</div><div type="abstract">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.</div><div type="abstract">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.</div><div type="abstract">Treating obesity in children Childhood obesity affects both the physical and psychosocial health of children and may put them at risk of ill health as adults. More information is needed about the best way to treat obesity in children and adolescents. In this review, 64 studies were examined including 54 studies on lifestyle treatments (with a focus on diet, physical activity or behaviour change) and 10 studies on drug treatment to help overweight and obese children and their families with weight control. No surgical treatment studies were suitable to include in this review. This review showed that lifestyle programs can reduce the level of overweight in child and adolescent obesity 6 and 12 months after the beginning of the program. In moderate to severely obese adolescents, a reduction in overweight was found when either the drug orlistat, or the drug sibutramine were given in addition to a lifestyle program, although a range of adverse effects was also noted. Information on the long‐term outcome of obesity treatment in children and adolescents was limited and needs to be examined in some high quality studies.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Groningue (province)</li><li>Nouvelle-Galles du Sud</li></region><settlement><li>Groningue</li><li>Sydney</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><country name="Pays-Bas"><region name="Groningue (province)"><name sortKey="Oude Luttikhuis, Hiltje" sort="Oude Luttikhuis, Hiltje" uniqKey="Oude Luttikhuis H" first="Hiltje" last="Oude Luttikhuis">Hiltje Oude Luttikhuis</name></region><name sortKey="Jansen, Hanneke" sort="Jansen, Hanneke" uniqKey="Jansen H" first="Hanneke" last="Jansen">Hanneke Jansen</name><name sortKey="Oude Luttikhuis, Hiltje" sort="Oude Luttikhuis, Hiltje" uniqKey="Oude Luttikhuis H" first="Hiltje" last="Oude Luttikhuis">Hiltje Oude Luttikhuis</name><name sortKey="Oude Luttikhuis, Hiltje" sort="Oude Luttikhuis, Hiltje" uniqKey="Oude Luttikhuis H" first="Hiltje" last="Oude Luttikhuis">Hiltje Oude Luttikhuis</name><name sortKey="Stolk, Ronald P" sort="Stolk, Ronald P" uniqKey="Stolk R" first="Ronald P" last="Stolk">Ronald P. Stolk</name></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Baur, Louise" sort="Baur, Louise" uniqKey="Baur L" first="Louise" last="Baur">Louise Baur</name></region><name sortKey="Shrewsbury, Vanessa A" sort="Shrewsbury, Vanessa A" uniqKey="Shrewsbury V" first="Vanessa A" last="Shrewsbury">Vanessa A. Shrewsbury</name></country><country name="Royaume-Uni"><noRegion><name sortKey="O Malley, Claire" sort="O Malley, Claire" uniqKey="O Malley C" first="Claire" last="O'Malley">Claire O'Malley</name></noRegion><name sortKey="Summerbell, Carolyn D" sort="Summerbell, Carolyn D" uniqKey="Summerbell C" first="Carolyn D" last="Summerbell">Carolyn D. Summerbell</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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