Treatment of pediatric obesity: An umbrella systematic review

Tamim Rajjo, Khaled Mohammed, Mouaz Alsawas, Ahmed T. Ahmed, Wigdan Farah, Noor Asi, Jehad Almasri, Larry J. Prokop, Mohammad H Murad

Research output: Contribution to journalReview article

31 Citations (Scopus)

Abstract

Objective: Multiple interventions are available to reduce excess body weight in children. We appraised the quality of evidence supporting each intervention and assessed the effectiveness on different obesity-related outcomes. Methods: We conducted a systematic search for systematic reviews of randomized controlled trials evaluating pediatric obesity interventions applied for 6 months. We assessed the quality of evidence for each intervention using GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. Results: From 16 systematic reviews, we identified 133 eligible randomized controlled trials. Physical activity interventions reduced systolic blood pressure and fasting glucose (low to moderate quality of evidence). Dietary interventions with low-carbohydrate diets had a similar effect to low-fat diets in terms of body mass index (BMI) reduction (moderate quality of evidence). Educational interventions reduced waist circumference, BMI, and diastolic blood pressure (low quality of evidence). Pharmacological interventions reduced BMI (metformin, sibutramine, orlistat) and waist circumference (sibutramine, orlistat) and increased high-density lipoprotein cholesterol (sibutramine) but also raised systolic and diastolic blood pressure (sibutramine). Surgical interventions (laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy) resulted in the largest BMI reduction (moderate quality of evidence). Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education significantly reduced systolic and diastolic blood pressure, BMI, and triglycerides. Combined parent-child interventions and parent-only interventions had similar effects on BMI (low quality of evidence). Conclusions: Several childhood obesity interventions are effective in improving metabolic and anthropometric measures. A comprehensive multicomponent intervention, however, appears to have the best overall outcomes.

Original languageEnglish (US)
Pages (from-to)763-775
Number of pages13
JournalJournal of Clinical Endocrinology and Metabolism
Volume102
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

sibutramine
Pediatrics
Pediatric Obesity
Blood pressure
Blood Pressure
Body Mass Index
Nutrition
Metformin
Waist Circumference
Therapeutics
HDL Cholesterol
Triglycerides
Randomized Controlled Trials
Education
Fats
Carbohydrates
Carbohydrate-Restricted Diet
Exercise
Diet Therapy
Glucose

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Treatment of pediatric obesity : An umbrella systematic review. / Rajjo, Tamim; Mohammed, Khaled; Alsawas, Mouaz; Ahmed, Ahmed T.; Farah, Wigdan; Asi, Noor; Almasri, Jehad; Prokop, Larry J.; Murad, Mohammad H.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 102, No. 3, 01.03.2017, p. 763-775.

Research output: Contribution to journalReview article

Rajjo, T, Mohammed, K, Alsawas, M, Ahmed, AT, Farah, W, Asi, N, Almasri, J, Prokop, LJ & Murad, MH 2017, 'Treatment of pediatric obesity: An umbrella systematic review', Journal of Clinical Endocrinology and Metabolism, vol. 102, no. 3, pp. 763-775. https://doi.org/10.1210/jc.2016-2574
Rajjo, Tamim ; Mohammed, Khaled ; Alsawas, Mouaz ; Ahmed, Ahmed T. ; Farah, Wigdan ; Asi, Noor ; Almasri, Jehad ; Prokop, Larry J. ; Murad, Mohammad H. / Treatment of pediatric obesity : An umbrella systematic review. In: Journal of Clinical Endocrinology and Metabolism. 2017 ; Vol. 102, No. 3. pp. 763-775.
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