Effect of obesity treatment interventions in preschool children aged 2–6 years: a systematic review and meta-analysis

OBJECTIVES: (1) To summarise the literature on the impact of paediatric weight management interventions on health outcomes in preschool age children with overweight or obesity and (2) to evaluate the completeness of intervention description and real-world applicability using validated tools. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, CINAHL, Cochrane Library and PsychInfo were searched between 10 March 2015 and 21 November 2021. ELIGIBILITY CRITERIA: Randomised controlled trials addressing weight management in preschool children (2-6 years) with overweight or obesity. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted key information from each study and assessed risk of bias. Random-effects meta-analysis was performed where there was evidence for homogeneous effects. The certainty of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation. RESULTS: Of the 16 908 studies retrieved, 9 trials (1687 participants) met the inclusion criteria. These interventions used motivational interviewing (MI) or multicomponent educational interventions related to health behaviour approaches and were 6-12 months in duration. All studies contained some risk of bias. A difference was found in the intervention groups compared with controls for body mass index (BMI) z score (mean difference -0.10, 95% CI -0.12 to -0.09; eight trials, 1491 participants; p<0.001; I² 68%), though there was substantial heterogeneity. There were no subgroup effects between studies using MI compared with studies using multicomponent interventions. The certainty of the evidence was considered low. The trials were reported in sufficient detail and were considered pragmatic. CONCLUSIONS: Paediatric weight management interventions delivered to the parents of young children with obesity result in small declines in BMI z score. The results should be interpreted cautiously as they were inconsistent and the quality of the evidence was low. PROSPERO REGISTRATION NUMBER: CRD42020166843.