Abstract
An effective behavior change program is the first line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support, among other environmental factors. The aim of this systematic review is to compare the impact of two types of obesity prevention programs, inclusive of behavior change components, on weight outcomes. “Energy-balance” studies are aimed at reducing calories from high-energy sources and increasing physical activity (PA) levels, while “shared risk factors for obesity and eating disorders” focus on reducing disordered eating behaviors to promote a positive food and eating relationship. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Thirty-five studies were included in the review, of which 20 regarded “energy-balance” and 15 “shared risk factors for obesity and eating disorders”. “Energy-balance” studies were unable to support maintenance weight status, diet, and PA. “Shared risk factors for obesity and eating disorders” programs also did not result in significant differences in weight status over time. However, the majority of “shared risk factors for obesity and eating disorders” studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. Research is needed to examine how a shared risk factor approach can address both obesity and eating disorders.
Highlights
Pediatric obesity is a well-accepted major public health concern [1]
This systematic review showed that energy-balance interventions produced better results on weight outcomes when integrating physical activity associated with changes in school or other community environments
Improved disordered risk factors were seen in the shared risk factors, e.g., weight-control behaviors and shape and weight concerns, especially among overweight adolescents
Summary
Pediatric obesity is a well-accepted major public health concern [1]. The World Health Organization (WHO) defines pediatric obesity as a body mass index (BMI) at or above the 95th percentile among children and adolescents of the same age and sex, often measured on BMI growth charts [2]. Children with obesity experience weight stigmatization, defined as the societal devaluing of an individual because of their body size [3], which often manifests in childhood as weight-based teasing and bullying [3] Due to this stigmatization, obesity in youth has been shown to be a risk factor for psychopathology, which may manifest itself through body dissatisfaction, shape and weight concerns, and dieting and eating disorder behaviors, such as binge eating and purging [4,5]. The term “eating disorder” refers to a psychiatric disorder and include the following four categories: anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and avoidant restrictive food intake disorder (ARFID) [8] Those individuals who do not meet the specific diagnostic criteria of an eating disorder may fall into the category of a weight-related disorder, which includes disordered eating behaviors [9]
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