Evidence map›Paper›PMID 25844368›Full record

ArticleCMAJ open

Treatment of overweight and obesity in children and youth: a systematic review and meta-analysis.

Leslea Peirson, Donna Fitzpatrick-Lewis, Katherine Morrison, Rachel Warren, Muhammad Usman Ali, Parminder Raina

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 20 pooled it
17.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 20 syntheses or guidelines pooled it, 147 citations in OpenAlex.

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  17. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2017 · on this map
    Guideline
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  20. Recommendations for growth monitoring, and prevention and management of overweight and obesity in children and youth in primary care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015
    Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Leslea PeirsonMcMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario ; School of Nursing, McMaster University, Hamilton, Ontario.
Donna Fitzpatrick-LewisMcMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario ; School of Nursing, McMaster University, Hamilton, Ontario.
Katherine MorrisonDepartment of Pediatrics, McMaster University, Hamilton, Ontario.
Rachel WarrenMcMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario ; School of Nursing, McMaster University, Hamilton, Ontario.
Muhammad Usman AliMcMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Parminder RainaMcMaster Evidence Review and Synthesis Centre, McMaster University, Hamilton, Ontario ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
McMaster University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildhood obesity is a public health concern. One-third of North American children and youth are overweight or obese. We reviewed the evidence of behavioural and pharmacological weight-management interventions on body mass index (BMI), BMI z-score and the prevalence of overweight and obesity in children and youth.

methodsWe updated the search of a previous review. We searched 4 databases up to August 2013. We included randomized trials of primary care-relevant behavioural (diet, exercise, lifestyle) and pharmacological (orlistat) interventions for treating overweight and obesity in children and youth aged 2-18 years if 6-month post-baseline data were provided for BMI, BMI z-score or prevalence of overweight and obesity. In addition, we examined secondary health outcomes such as lipid and glucose levels, blood pressure, quality of life and physical fitness. We included any study reporting harms. We performed meta-analyses when possible, and we examined the features of interventions that showed benefits.

resultsThirty-one studies (29 behavioural, 2 pharmacological and behavioural) were included. Both intervention types showed a significant effect on BMI or BMI z-score in favour of treatment (behavioural: standardized mean difference [SMD] -0.54, 95% confidence interval [CI] -0.73 to -0.36; orlistat plus behavioural: SMD -0.43, 95% CI -0.60 to -0.25). Studies reported no significant difference between groups in the likelihood of reduced prevalence of overweight or overweight and obesity. Pooled estimates for blood pressure and quality of life showed significant benefits in favour of treatment (systolic blood pressure mean difference [MD] -3.42, 95% CI -6.65 to -0.29; diastolic blood pressure MD -3.39, 95% CI -5.17 to -1.60; quality of life MD 2.10, 95% CI 0.60 to 3.60). Gastrointestinal difficulties were more common in youth taking orlistat than in the control group (risk ratio 3.77, 95% CI 2.56 to 5.55). We saw much variability across efficacious interventions.

interpretationLow- to moderate-quality evidence suggests behavioural treatments are associated with a medium effect in terms of reduced BMI or BMI z-score compared with a small effect shown by combined pharmacological-behavioural interventions. Future research should evaluate active weight maintenance interventions in adolescents with longer follow-up and examine the effectiveness of combined pharmacological and behavioural interventions. REGISTRATION: PROSPERO no. CRD42012002754.

Identifiers

PMID25844368
PMCPMC4382035
OpenAlexW2161283213

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.