Pediatrics · Endocrinology · 2 h ago
More contact hours linked to stronger effects in pediatric obesity programs
A meta-analysis of 78 randomized trials involving 16,514 children and adolescents found a small overall benefit from behavioral interventions for weight-related outcomes. Study-level analyses linked greater total contact hours—and participation by both children and caregivers—with larger effects, although substantial between-study heterogeneity limits interpretation.
- Meta-analysis included 78 trials and 16,514 participants.
- Behavioral interventions had a small pooled effect on weight outcomes.
- More contact hours were associated with larger effects.
- Study-level associations do not establish an optimal dose.
Researchers conducted a systematic review and meta-regression of randomized trials of behavioral interventions for children aged 2–18 years with study-defined overweight or obesity. The analysis included 78 trials, representing 91 comparisons and 16,514 participants. Weight-related outcomes were prioritized in a prespecified hierarchy, beginning with BMI z score, and pooled using random-effects models.
The overall intervention effect was small (Hedges’ g −0.28; 95% CI, −0.35 to −0.21), with substantial heterogeneity (I²=73.4%). In adjusted meta-regression, greater total contact hours were associated with larger effects (β=−0.016; 95% CI, −0.027 to −0.004). Intervention duration and number of sessions were not consistently associated with effect size. Programs involving both children and caregivers also had larger effects than child-only programs (β=−0.271; 95% CI, −0.532 to −0.010).
The findings suggest that contact intensity and caregiver involvement may be relevant when designing behavioral programs, but they do not establish causal effects of either program feature. Because the analysis compared study-level characteristics, ecological bias and residual confounding are possible; the high heterogeneity also indicates that effects varied across trials. The results do not establish a specific optimal intervention dose.
In practice
For children and adolescents with overweight or obesity, this synthesis found a small average benefit from behavioral interventions, with greater total contact hours and inclusion of caregivers associated with larger effects. These findings may inform program design, but they do not show that increasing contact hours or adding caregivers will itself improve outcomes: the dose analyses were study-level comparisons, with potential ecological bias and residual confounding, and substantial heterogeneity across trials. The analysis does not identify an optimal dose or justify a specific change in clinical practice.
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BMC Medicine: Associations between behavioral intervention dose and outcomes in children and adolescents with obesity: meta-regression of randomized clinical trials ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.