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Meta-Analysis
. 2019 Sep;20(9):1287-1298.
doi: 10.1111/obr.12866. Epub 2019 May 26.

Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta-analysis

Hiba Jebeile  1   2 , Megan L Gow  1   2 , Louise A Baur  1   2 , Sarah P Garnett  1   2 , Susan J Paxton  3 , Natalie B Lister  1   2
Affiliations
Meta-Analysis

Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta-analysis

Hiba Jebeile et al. Obes Rev. 2019 Sep.

Abstract

This review aimed to investigate the impact of obesity treatment, with a dietary component, on eating disorder (ED) prevalence, ED risk, and related symptoms in children and adolescents with overweight or obesity. Four databases were searched to identify pediatric obesity treatment interventions, with a dietary component, and validated pre-post intervention assessment of related outcomes. Of 3078 articles screened, 36 met inclusion criteria, with a combined sample of 2589 participants aged 7.8 to 16.9 years. Intervention duration ranged from 1 week to 13 months, with follow-up of 6 months to 6 years from baseline. Prevalence of ED was reported in five studies and was reduced post-intervention. Meta-analyses showed a reduction in bulimic symptoms (eight studies, standardized mean difference [SE], -0.326 [0.09], P < 0.001), emotional eating (six studies, -0.149 [0.06], P = 0.008), binge eating (three studies, -0.588 [0.10], P < 0.001), and drive for thinness (three studies, -0.167 [0.06], P = 0.005) post-intervention. At follow-up, a reduction in ED risk (six studies, -0.313 [0.13], P = 0.012), emotional eating (five studies, -0.259 [0.05], P < 0.001), eating concern (three studies, -0.501 [0.06], P < 0.001), and drive for thinness (two studies, -0.375 [0.07], P < 0.001) was found. Structured and professionally run obesity treatment was associated with reduced ED prevalence, ED risk, and symptoms.

Keywords: dieting; disordered eating; pediatrics; weight loss.

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Conflict of interest statement

Authors have no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) flow diagram of the literature search and screening process
Figure 2
Figure 2
Meta‐analysis of the change in eating disorder risk between pre‐ and post‐intervention (A) and between baseline and the latest follow‐up timepoint (B), following obesity treatment with a dietary component in children and adolescents with overweight and obesity. ChEAT, Children's Eating Attitudes Test; ChEDE, Child Eating Disorder Examination; EAT, Eating Attitudes Test; EAT‐26, Eating Attitudes Test‐26 items; EDE, Eating Disorder Examination; IG, intervention group; KEDS, Kids Eating Disorder Survey
Figure 3
Figure 3
Meta‐analysis of the change in bulimic symptoms between pre‐ and post‐intervention (A) and between baseline and the latest follow‐up timepoint (B), following obesity treatment with a dietary component in children and adolescents with overweight and obesity. BITE, Bulimic Investigatory Test; ChEAT, Children's Eating Attitudes Test; EAT‐26, Eating Attitudes Test‐26 items; EDI, Eating Disorder Inventory; EDI‐II, Eating Disorder Inventory‐second edition; KEDS, Kids Eating Disorder Survey
Figure 4
Figure 4
Meta‐analysis of the change in binge eating between pre‐ and post‐intervention following obesity treatment with a dietary component in children and adolescents with overweight and obesity. BES, binge eating scale; ChEDE, Child Eating Disorder Examination; EDE, Eating Disorder Examination
Figure 5
Figure 5
Meta‐analysis of the change in emotional eating between pre‐ and post‐intervention (A) and between baseline and the latest follow‐up timepoint (B), following obesity treatment with a dietary component in children and adolescents with overweight and obesity. Combined, combined subscales of the emotional eating scale; DEBQ, Dutch Eating Behaviour Questionnaire; EPI‐C, Eating Pattern Inventory for Children; IG, intervention group; TFEQ, Three‐Factor Eating Questionnaire
Figure 6
Figure 6
Meta‐analysis of the change in drive for thinness between pre‐ and post‐intervention (A) and between baseline and the latest follow‐up timepoint (B), following obesity treatment with a dietary component in children and adolescents with overweight and obesity. EDI, Eating Disorder Inventory; EDI‐II, Eating Disorder Inventory‐second edition
Figure 7
Figure 7
Meta‐analysis of the change in eating concern between pre‐ and post‐intervention (A) and between baseline and the latest follow‐up timepoint (B), following obesity treatment with a dietary component in children and adolescents with overweight and obesity. ChEDE, Child Eating Disorder Examination; EDE, Eating Disorder Examination; EDE‐Q, Eating Disorder Examination Questionnaire
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