Article
Effective Weight Loss for Overweight Children: A Meta-Analysis of Intervention Studies

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Childhood overweight has increased in the United States. Success of weight-loss programs has been limited (Barlow, S.E., & Dietz, W.H. (1998). Obesity evaluation and treatment: Expert committee recomendations. Pediatrics, 102, e29.). The purpose of this investigation was to systematically examine the effectiveness of weight-loss interventions for children. For this meta-analysis, seven weight-loss intervention studies were coded and quality index scores calculated. The interventions had a significant positive effect on weight-loss average d = 0.95, with a 95% confidence interval of 0.79 to 1.11. Limited interventional studies with effective long-term maintenance of weight loss in children are available in the literature. However, there are effective methods for weight loss in children.

Section snippets

Magnitude of the Problem

Data from the CDC indicate there are significantly increasing numbers of young children under the age of 5 years and across all ethnic groups who are overweight (Mei et al., 1998, Ogden et al., 1997). Increasing numbers of children have BMI at or above the 95th percentile, with 15.3% of children 6–11 years having a BMI of ≥95th percentile (Krebs et al., 2003) and therefore considered overweight according to the CDC guidelines. The World Health Organization (1998) has identified

Genetic and Environmental Factors

Overweight/obesity is a complex chronic condition in children, with many factors that contribute to the problem (Borra, Kelly, Shirreffs, Neville, & Geiger, 2003). Heredity is one contributing factor, as children within particular ethnic backgrounds have higher rates of overweight/obesity than children from other ethnic backgrounds because of inherited factors (Eissa & Gunner, 2004, Satcher, 2004, Strauss & Pollack, 2001). In addition, environmental factors within a specific culture can

Meta-Analysis

Meta-analysis is a quantitative synthesis of research, using formal statistical techniques. It allows the researcher to obtain findings more objective than traditional reviews of literature (Curlette & Cannella, 1985, Sacks et al., 1996). Therefore, we conducted a meta-analysis of intervention studies designed to reduce an overweight or obese child's weight and improve activity and nutrition patterns (Buyse, Piedbois, Piedbois, & Carlson, 2000).

Literature Search Strategy

A literature search was conducted to identify

Description of Studies

Seven weight-loss intervention studies for school-age children, published between 1980 and 2002, met the criteria for inclusion in the meta-analysis. The seven studies included a total of 356 participants in 14 different interventions and 144 children in 7 different control groups (see Table 1).

Statistical Analyses

The primary outcome of interest in a meta-analysis is the combined overall effect size for the study and is independent of sample size. An effect size is a measure of how large a treatment effect was. In this study, the effect size Cohen's d was used. Cohen's d is a standardized measure of difference between two means and is one of the most commonly used measures of effect size. This measure of effect is the magnitude of the distance between two groups' means in number of standard deviations.

Discussion

Concern for children who are overweight/obese has become increasingly evident in the literature. However, there are still a limited number of intervention studies with control groups that focus on weight loss in children. The effect sizes from the studies in the meta-analysis suggest that the use of structured dietary and exercise regimens are effective in assisting children to lose weight and maintain weight loss. In addition, there are a combination of factors that could be incorporated to

Conclusion

The findings of this investigation support that there are effective treatments for children who are overweight/obese. A combination of variables, dietary, physical activity, behavioral change, and parental involvement can be effective in assisting children to effectively lose weight. Yet, there is not enough data to support one variable as being more effective as a weight-loss intervention than another variable, similar to the findings reported in previous research (Campbell et al., 2001,

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