The Effectiveness of Integrating Psychotherapy Into Overweight/Obesity Interventions on Youth’s Weight Status and Depressive Symptoms: A Narrative Review

Abstract

Introduction: Childhood obesity and youth depression are serious ongoing global crises of the 21st century. Many researchers have often attributed this to the well-established association between them. Consequently, psychotherapies are increasingly being integrated into interventions to improve weight status and depression outcomes for individuals with overweight and/or obesity (OW/OB). However, the effectiveness of these interventions has not yet been reviewed for youth with OW/OB. Such youth tend to be at a higher risk of developing comorbid depressive symptoms, which can likely persist into adulthood. Therefore, this narrative review explored the effectiveness of psychotherapy integrations within OW/OB interventions on youth’s weight statuses and their depressive symptoms contemporaneously. Methods: Medline, Embase, PsycInfo, PubMed, and Scopus were accessed. English peer-reviewed empirical articles, reviews, meta-analyses, clinical trials, and pilot studies from the last ten years and those that investigated the effectiveness of OW/OB interventions integrated with psychotherapy among youth (5-18 years) were included. Keywords related to diet, psychotherapy, OW/OB, youth, and depression were used. Non-peer-reviewed sources, reviews lacking sufficient transparency in their methodology, editorials, letters, study protocols, commentaries, preprints, and dissertations were excluded. Results: Four studies, including two pilot studies, were included. Overall, we found high heterogeneity in their intervention components and conditions, study designs, participants, and results. Among youth, all studies found no significant improvements in weight status as per the authors’ set significance thresholds. Mixed results were obtained for the effect on youth’s depressive symptoms. Discussion: There is an alarming lack of recent literature investigating the impact of integrated evidence-based psychotherapies within OW/OB interventions on youth’s weight statuses and depressive symptoms. It is important to investigate their effectiveness in equipping youth with OW/OB with skills to make sustained lifestyle changes and cope with weight discrimination and depressive symptoms. We attributed the weak success of these interventions to the lack of cultural adaptations and standardization of study types, intervention structures, components, and conditions. Conclusion: It is important for researchers to continue investigating the success of such interventions on youth with OW/OB’s physical and mental outcomes simultaneously. This will further inform the interdisciplinary approach needed to deliver appropriate care to these youth.