ABSTRACT

Objective

This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents.

Method

Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022.

Results

Family-based treatment (FBT) remains a well-established treatment for overweight and obesity in children and is now well-established in adolescents and toddlers. Parent-only behavioral treatment remains well-established in children and is now well-established among adolescents and children. Possibly effective treatments continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered possibly effective including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for possibly effective treatments. Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth).

Conclusions

Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.

中文翻译：

---

儿童和青少年超重和肥胖行为治疗的证据基础更新

摘要

客观的

本综述对之前针对儿童和青少年超重和肥胖行为治疗的证据基础更新进行了更新。

方法

通过系统检索 PubMed/MEDLINE (1946-)、Elsevier EMBASE (1947-)、SCOPUS (1823-)、Clarivate Web of Science Core Collection (WOS, 1900-)、PsycINFO (1800-) 中的生物医学文献来确定文章），Cochrane 图书馆和 ClinicalTrials.gov 于 2014 年 6 月至 2022 年 8 月期间出版。

结果

基于家庭的治疗（FBT）仍然是治疗儿童超重和肥胖的一种行之有效的治疗方法，目前在青少年和幼儿中也得到了广泛应用。仅由家长进行的行为治疗在儿童中仍然很成熟，现在在青少年和儿童中也很成熟。可能有效的治疗方法仍然包括仅针对青少年的 FBT 父母，以及针对青少年、儿童和幼儿的带有家庭成分的行为减肥 (BWL)。现在可以认为 FBT 和 BWL 的几种变体可能有效，包括 FBT+动机访谈、FBT+社会促进维持、基于小组的 FBT、低剂量 FBT、BWL+压力管理和基于营地的 BWL。针对青少年的认知行为治疗（CBT）也符合可能有效的治疗标准。目前的研究还表明，可以在替代环境（例如初级保健）和通过替代媒介（例如远程医疗）中有效地提供行为治疗。

结论

根据美国儿科学会、美国心理学会和美国预防服务工作组最近的建议，研究继续支持使用多成分生活方式干预措施。然而，需要做更多的工作来确保患有共存疾病和精神疾病的儿童以及来自社会、政治和经济边缘群体的儿童获得适当的服务。