Neighborhood Environments and Changes in Obesity and in Lifestyle Behaviors Among Children Enrolled in Obesity Management Interventions: A Systematic Review

INTRODUCTION: Neighborhood determinants of health have been documented in several populations, yet less is known about their role in pediatric obesity treatment. A systematic review of longitudinal studies examining associations between neighborhood environment features and changes in obesity and in lifestyle behaviors among children participating in obesity management interventions was conducted. METHODS: Searches were conducted in Medline, Embase, CINAHL, and Web of Science for peer-reviewed articles published in English from database inception until April 2025. We included studies of children with overweight/obesity at baseline, participating in multicomponent obesity management interventions, and with at least one pre- and one post-intervention measurement of obesity or lifestyle behaviors. RESULTS: Of the 27,310 records screened, six met inclusion criteria. Studies were conducted in the United States (n = 5) and United Kingdom (n = 1), with participants' age ranging from 6 to 18 years, and a total of 13,364 participants. Studies examined availability of parks (n = 3), supermarkets (n = 2), greenspaces (n = 1), walkability (n = 1), recreational facilities (n = 1), and neighborhood deprivation (n = 1). Residing in neighborhoods with more parks was associated with greater reductions in post-intervention body mass index in two studies. Inconsistent findings relating availability of supermarkets to changes in fruit and vegetable intake were reported. Residing in neighborhoods with more recreational facilities was associated with increases in objectively measured physical activity but not with self-reported screen time. CONCLUSION: Findings among the few studies that examined neighborhood determinants of obesity management outcomes among children were inconsistent. Neighborhood resources that support physical activity (parks, recreational facilities) may be associated with better outcomes.