| Study Reference | N Randomized Country |
Age % Male % Non-white |
Baseline Measure of Overweight | Intervention Characteristicsa | |
|---|---|---|---|---|---|
| Components Comprehensive? Parent participation? Group vs. Indiv. |
Time period # of Sessions Session length Total contact time (min) |
||||
| Berkowitz, 200386 | 82 adolescents USA |
13-17 33% 45% |
BMI 37.8 kg/m2 (3.8); BMI z-score: 2.4 (0.2) |
BM,D,E yes yes G |
6 mo (phase I) 19 (phase I) NR NR |
| Duffy, 199387 | 29 children Australia |
7-13 21% NR, Australian |
48.4% overweight | BM,D,E yes yes NR |
8 wk 8 90 in 720 min |
| Ebbeling, 200388 | 16 adolescents USA |
13-21 31% 19% |
BMI 34.9 kg/m2 (reduced glycemic
group); 37.1 kg/m2(reduced fat diet group) |
BM,D No No NR |
12 mo 14 NR NR |
| Epstein, 198589 | 41 families USA |
8-12 40% NR |
48% overweight | BM,D,E yes yes NR |
12 mo 18 NR NR |
| Epstein, 198590 | 23 children USA |
8-12 0% NR |
48 % overweight | BM,D,E yes yes NR |
12 mo NR NR NR |
| Epstein, 198591 | 24 children USA |
5-8 0% NR |
39-42% overweight | BM,D,E yes yes G, unclear if I |
12 mo unclear, approx 26 NR NR |
| Epstein, 199492 | 44 families USA |
8-12 26% NR |
59.6% over the 50th%ile for BMI | BM,D,E yes yes unclear |
1 yr 32 NR NR |
| Epstein, 199593 | 61 families USA |
8-12 27% 4% |
51.8% overweight | BM,D,E yes yes I + G |
6 mo 18 NR NR |
| Epstein, 200094 | 90 families USA |
8-12 32% NR |
62% overweight | BM,D,E yes yes I + G |
6 mo 20 45-60 min 900-1200 min |
| Epstein, 200095/ Epstein, 200196 |
67 children USA |
NR, mean (sd) 10.3 (1.1)
yrs 48% 4% |
BMI 27.4 kg/m2(3.2) | BM,D,E yes yes I + G |
6 mo 18 45-60 min 810-1080 min |
| Epstein, 200196 | 67 families USA |
8-12 52% NR |
60.2% overweight
(compared to the 50%ile BMI for age and sex); BMI 27.4 kg/m2 (3.6 kg/m2) |
BM, D,E yes yes I + G |
6 mo 20 30 min 600 min |
| Flodmark, 199397 | 44 children (plus 50 matched controls) Sweden |
10-11 48% NR (Swedish) |
24.7 kg/m2 (family therapy
group); 25.5 kg/m2(conventional treatment group); 25.1 kg/m2(control group) |
D,E no yes I |
14-18 mo 5 + 6 family therapy sessions NR NR |
| Golan, 199898 | 60 children Israel |
6-11 38% NR (Israeli) |
39.1% overweight (conventional group); 39.6% (parents agents of change group) |
BM,D,E yes noa G+I |
1 yr 30 60 min 1800 min |
| Graves, 198899 | 40 children USA |
6-12 NR NR |
52%-56% overweight | BM,D,E yes yes G |
8 wk 8 60 min 480 min |
| Israel, 1985100 | 33 children USA |
8-12 30% NR |
45.88% overweight (parent training group); 53.13% (BT only); 56.02% (controls) |
BM,D,E yes yes G |
12 mo 17 same +2-60 min sessions >930 min |
| Israel, 1994101 | 36 families USA |
8-13 NR NR |
48.1% overweight (enhanced child involvement
group); 46.0% (standard treatment group) |
BM,D,E yes yes G |
26 wk 17 90 min 1530 min |
| Kang, 2002103/ Gutin, 2002102 |
80 USA |
13-16 33% 69% |
40.7% body fat (white boys); 45.8% body fat (white girls); 43.9% body fat (black boys); 45.2% body fat (black girls) | BM,E no no G |
8 mo 160 60 min for LSE, variable for PA NR |
| Mellin, 1987104 | 66 adolescents USA |
12-18 21% 22% |
30-37% overweight | BM,D,E yes yes G |
14 wk 16 90 min 1440 min |
| Saelens, 2002105 | 44 USA |
12-16 59% 30% |
BMI 30.7kg/m2 (3.1) | BM,D,E yes no I |
4 mo 13 10-20 min for TC, NR for visit NR, > 200 min |
| Senediak, 1985106 | 45 children USA |
6-13 approximately 66% NR |
37.22% overweight | BM,D,E yes yes G |
4 wk 8 90 min 720 min |
| Wadden, 1990107 | 47 girls USA |
12-16 0% 100% black |
95.1 kg; BMI 35.6 kg/m2 |
BM,D,E yes yes G |
10 mo 22 60 min (first 16 sessions), others NR >960 min |
| White, 2003108/ Williamson, unpublished data |
57 adolescents USA |
11-15 0% 100% |
BMI 36.34 kg/m2; 98.3 BMI %ile |
BM,D,E yes yes I |
6 mo 4 + weekly Web site logins NR NR |
| Study Reference | Group | Units of Measure | Study Duration | Outcome at Latest Followup Time | P Value for Comparisons Between Groupsb | Other Outcomes | USPSTF Quality Grade |
|---|---|---|---|---|---|---|---|
| Berkowitz, 200386 | Sibutramine | change in BMI (% change from entry BMI) | 6 months | -8.5% | p = 0.001 | P, A | Good |
| Placebo | -4.0% | ||||||
| Duffy, 199387 | BT + cognitive self-management | % overweight change | 6 months | -8.9% | n.s. | B | Fair-to-Poor |
| BT + relaxation placebo | -9.2% | ||||||
| Ebbeling, 200388 | Reduced glycemic load diet | absolute change in BMI | 12 months | -1.2 kg/m2 | p < 0.05 | B, P | Fair |
| Reduced fat diet | 0.6 kg/m2 | ||||||
| Epstein, 198589 | Lifestyle PA | % overweight change | 24 months | -18.0% | <0.05, lifestyle PA vs. Aerobic PA; <0.05, lifestyle PA vs. calisthenics PA |
B, P | Fair |
| Aerobic PA | -6.8% | ||||||
| Low-intensity calisthenics PA | -7.2% | ||||||
| Epstein, 198590 | Diet + PA | % overweight change | 12 months | -25.4% | n.s. | B, P | Fair |
| Diet alone | -18.7% | ||||||
| Epstein, 198591 | BT | % overweight change | 12 months | -26.3% | <0.05 | B | Fair |
| Education only | -11.2% | ||||||
| Epstein, 199492 | Mastery criteria & contingent reinforcement group | % overweight change | 24 months | -15.4% | n.s. | B | Fair |
| Comparison group | -10.6% | ||||||
| Epstein, 199593 | Combined | % overweight change | 12 months | -8.7% | p < 0.05, combined vs. increased PA | B, P | Fair |
| Decreased SB | -10.3% | ||||||
| Increased PA | -18.7% | ||||||
| Epstein, 200094 | Decreased SB high dose | % overweight change | 24 months | -14.3% | n.s. | B, P | Fair |
| Decrease SB low dose | -11.6% | ||||||
| PA high dose | -13.2% | ||||||
| PA low dose | -12.4% | ||||||
| Epstein, 200095/ Epstein, 200196 |
PS to parent and child | change in BMI z-score | 24 months | -0.5 | p < 0.05, PS to parent and child vs. no PS; p < 0.05, PS to parent and child vs. PS to child only |
H, A | Fair |
| PS to child only | -0.9 | ||||||
| No PS | -1.1 | ||||||
| Epstein, 200196 | Increased PA | change in absolute BMI (statistical comparisons done on percent overweight change) | 12 months | girls: -0.27 kg/m2; boys: -0.65 kg/m2 |
p < 0.01, interaction
of group by sex; p < 0.001, boys in combined group vs. girls in combined group p < 0.05, boys in combined group vs. girls in increased PA group |
none | Fair |
| Combined increased PA + decreased SB | girls: 1.0 kg/m2; boys: -1.76 kg/m2 | ||||||
| Flodmark, 199397 | Family therapy | change in BMI (kg/m2) | 26-30 months | 1.1 kg/m2 | p < 0.05, family therapy vs. untreated controls | P | Fair |
| Conventional treatment | 1.6 kg/m2 | ||||||
| Matched controls, untreated | 2.8 kg/m2 | ||||||
| Golan, 199898 | Conventional: children responsible for own wt loss | % overweight change | 12 months | -8.1% | p < 0.05 | none | Fair |
| Parents exclusive agents of change | -14.7% | ||||||
| Graves, 198899 | BT + parent PS | % overweight change | 6 months | -24.5% | p < 0.05, PS vs BT
only; p < 0.05, PS vs. instruction only |
B | Fair |
| BT only | -10.2% | ||||||
| Instruction only | -9.5% | ||||||
| Israel, 1985100 | BT + parent training in child management | % overweight change | 12 months | -10.2% | p < 0.001 per NHS review | B | Fair-to-Poor |
| BT only | -1.3% | ||||||
| Wait list controls | NR | ||||||
| Israel, 1994101 | Enhanced child involvement | % overweight change | 36 months | -4.8% | n.s. | none | Fair-to-Poor |
| Standard treatment (parents primarily responsible) | 6.4% | ||||||
| Kang, 2002103/ Gutin, 2002102 |
LSE + high intensity PA | change in % body fat | 8 months | -2.9% | n.s. | B, P | Fair-to-Poor |
| LSE + moderate PA | -1.4% | ||||||
| LSE | -0.1% | ||||||
| Mellin, 1987104 | SHAPEDOWN group (Cognitive, behavioral, affective treatment) | % overweight change | 15 months | -9.9% | Between group comparison
NR (15 months vs. baseline: p < 0.01, SHAPEDOWN; n.s., control group) |
B, H | Fair |
| No treatment controls | -0.1% | ||||||
| Saelens, 2002105 | Healthy habits intervention | % overweight change & change in BMI (statistical analyses on BMI z-scores) | 7 months | -2.4%, 0.1 kg/m2 | n.s. | B, A | Good |
| Typical care | 4.1%, 1.4 kg/m2 | ||||||
| Senediak, 1985106 | Rapid schedule BT | % overweight change | 6 months | -14.7% | p < 0.05, rapid and gradual schedule BT
groups combined vs. non-specific controls; (comparison of rapid vs. gradual schedule BT groups n.s.) |
B | Fair-to-Poor |
| Gradually decreasing schedule BT | -18.3% | ||||||
| Non-specific treatment controls | -10.9% | ||||||
| Wait list controls | NR | ||||||
| Wadden, 1990107 | Mother and child together | change in weight | 6 months | 1.7 kg | n.s. | P, H | Fair-to-Poor |
| Child alone | 3.0 kg | ||||||
| Mother and child separate | 3.5 kg | ||||||
| White, 2003108/ Williamson, unpublished data |
Behavioral | change in % body fat; change in BMI | 6 months | -1.12%; -0.19 kg/m2 | p < 0.05 (% body fat); p < 0.05 (change in BMI) | B | Good |
| Education only | 0.43%; 0.65 kg/m2 |
aFor most intensive intervention which is
listed first.
bIf multiple
comparisons, then presented only if p < 0.05.
Notes: Intervention
characteristics: BM = behavior modification; D = special diet; E = exercise
program; G = group; I = individual.
Other outcomes: B =
behavioral ; p = physiological; H = childhood health outcomes; A = adverse
effects.