Changes in Psychosocial Outcomes Reported in Behavioral Intervention Trials for Children and Adolescents with Overweight and Obesity: A Scoping Review.

BACKGROUND

Pediatric obesity is associated with co-occurring psychosocial conditions, which may be impacted by obesity treatment. Past systematic reviews have shown positive effects for specific psychosocial outcomes following behavioral interventions. This review aimed to extend these findings by mapping patterns of change for the totality of psychosocial outcomes reported.

METHODS

We conducted a scoping review following published guidelines. We searched 11 databases to identify behavioral intervention trials for children and adolescents living with overweight or obesity that measured at least one psychosocial outcome pre-post. Outcomes were grouped into categories thematically, and data were synthesized based on the timepoint (post-intervention, latest follow-up), intervention arm (active, no-intervention control), and type of change reported (difference between arms, change over time).

RESULTS

Of 1172 articles screened, 197 articles (169 trials) met the inclusion criteria, with a combined sample of 18,694 children and adolescents. A total of 372 outcomes were identified and grouped into eight constructs. Across all outcomes and timepoints, many trials reported no difference or a difference favoring the active intervention arm over the no-intervention control arm. Likewise, most active intervention arms showed improvements or no change over time, though five of 169 trials reported worsening in a psychosocial outcome at post-intervention. Most no-intervention control arms showed no change over time.

CONCLUSIONS

Behavioral interventions are associated with improvements or no change in psychosocial health across a broad range of outcomes assessed. Consensus on core psychosocial outcomes is needed to reduce heterogeneity and ensure outcomes are relevant to children and adolescents living with obesity.