Hoek, Ev, Et Al. (2014) Effective Interventions

Hoek, EV, et al. (2014) Effective Interventions in Overweight or Obese Young Children: Systematic Review and Meta-Analysis. Childhood Obesity. 2014 Dec. Vol. 1, No. 8.

It is reported in this study that programs for treating young children who are overweight and obese vary in their effectiveness. This is likely because the programs that are effective have unknown characteristics. This study relates a systematic review in combination with meta-analysis examining the effectiveness of treating young children who are overweight and obese. The methodology of the study was such that examined four databases including: (1) PubMed; (2) Embase, (3) Web of Science; and (4) psycINFO through April 2012 and specifically that examined articles that reported treatment success in children ranging from three to less than eight years of age who were obese or overweight. It is stated that "studies reporting the change in BMI z-score with standard-error were included in the meta-analysis…a random effects model was used." (p. 1) Programs with success in treatment are cited as those resulting in changes in "behavior (diet and activity level) and therefore decrease overweight and its consequences." (p.1) Behavioral therapy is cited as being used quite often in order to assist individuals in beginning and maintaining behavioral change. There are clinical guidelines produced by the UK, the United States and The Netherlands for treatment of children who are overweight or obese however; there are no recommendations for young children that are specific to the child's age. Reported as key words used in the database search were those of: (1) overweight; (2) children; (3) treatment; and (4) design. According to the study reported there were 11,250 articles identified while 2516 were duplicates. Following the titles, abstracts and articles being screened the researchers chose 50 articles for evaluation. Following evaluation 25 articles were excluded from the study. However, two more articles were located in the references and added to the review making a total of 27 articles under review in the study. The study was further narrowed down and finally the meta-analysis resulted in the use of 11 studies that included 20 treatment groups and a total of 1015 individuals as participants. Six of the treatment groups are reported to have followed a "multicomponent very low intensity treatment program." (p.8) Eight treatment groups received nutritional education and either physical activity or behavioral therapy. Both of these groups showed a non-significant effect. Findings in the multicomponent mid to high intensity group showed improvement in the change of EMI with an increase stated at approximately 104 kg/m2. There were very few randomized controlled trials identified in treating the lifestyle of obese or overweight children. The findings of the study state "Based on this review, the treatment of choice for overweight or obese young children is a multicomponent treatment program of moderate- to high-intensity treatment." (p. 10) Recommendations stated by the researchers following the findings in the study is that evaluation of treatment programs requires "additional information on change in knowledge, thinking patterns and behavior (dietary intake and PA patterns)." (p. 10) It is the opinion of this researcher that the researchers in this study were meticulous and that while beginning with in excess of 2500 studies they effectively narrowed down the studies for systematic review to 27 very relevant studies and conducted the meta-analysis on these studies. The study findings are valid in the opinion of this researcher as children with overweight and obesity need more than just a low-density treatment program and instead need nutritional education, physical activity increases along with behavioral therapy.