. 2026 Jan;21(1):e70074.

doi: 10.1111/ijpo.70074.

Components of Adolescent Behavioural Interventions With Eating Disorder Outcomes: Systematic Review With Intervention Mapping

Natalie B Lister^{1

2}, Rabia Khalid^{1

2}, Isabelle R Jardine¹, Samantha Pryde³, Hannah Melville^{1

2}, Anna L Seidler^{4

5

6}, Kylie E Hunter⁴, Amy L Ahern⁷, Louise A Baur^{1

2

8}, Caroline Braet⁹, Sarah P Garnett^{1

10}, Andrew J Hill¹¹, Sarah Maguire^{2

12}, Dasha Nicholls¹³, Susan J Paxton¹⁴, Milan K Piya^{15

16}, Amanda Sainsbury¹⁷, Katharine Steinbeck¹, Denise E Wilfley¹⁸, Kelly Cooper¹⁹, Genevieve Dammery^{2

12}, Alicia M Grunseit⁸, Faith Anne N Heeren²⁰, Rebecca A Jones^{7

21}, Theodore K Kyle²², Fiona Quigley²³, Molly Robbins²⁴, Jacqlyn Yourell²⁵, Melanie K Bean²⁶, Maxine P Bonham²⁷, Kerri N Boutelle²⁸, Michelle I Cardel^{20

21}, Katherine E Darling^{29

30}, Aimee L Dordevic²⁷, Dawn M Eichen²⁸, Leonard H Epstein³¹, Andrea B Goldschmidt³², Elissa Jelalian^{29

30}, Mara Cristina Lofrano-Prado³³, Tiffany Naets^{9

34}, Wagner L Prado³⁵, Hanna F Skjåkødegård^{36

37}, Yngvild Sørebø Danielsen^{38

39}, Richard I Stein¹⁸, Marian Tanofsky-Kraff^{40

41}, Annelies Van Eyck^{42

43}, Alaina P Vidmar^{44

45}, Jack A Yanovski⁴¹, Brittany J Johnson³, Hiba Jebeile^{1

2}; EDIT Collaboration

Collaborators, Affiliations

Collaborators

EDIT Collaboration:
Natalie B Lister, Hiba Jebeile, Anna L Seidler, Brittany J Johnson, Rabia Khalid, Hannah Melville, Sol Libesman, Ruth Tredinnick, Samantha Pryde, Caitlin M McMaster, Kylie E Hunter, Isabelle R Jardine, Sasha J Lorien, Amy L Ahern, Lisa Askie, Louise A Baur, Caroline Braet, Kelly Cooper, Genevieve Dammery, Sarah P Garnett, Rebecca Golley, Alicia M Grunseit, Faith Anne N Heeren, Andrew J Hill, Rebecca A Jones, Theodore K Kyle, Sarah Maguire, Dasha Nicholls, Susan J Paxton, Milan K Piya, Fiona Quigley, Molly Robbins, Amanda Sainsbury, Katharine Steinbeck, Denise E Wilfley, Jacqlyn Yourell, Rachel D Barnes, Melanie K Bean, Kristine Beaulieu, Maxine P Bonham, Kerri N Boutelle, Caroline Braet, Braulio Branco, Simona Calugi, Michelle I Cardel, Kelly M Carpenter, Hoi Lun Cheng, Riccardo Dalle Grave, Katherine E Darling, Brenda Davy, Marcelo Demarzo, Aimee L Dordevic, Dawn M Eichen, Leonard H Epstein, Andrea B Goldschmidt, Amy Gross, Faith Anne N Heeren, Anja Hilbert, Katrijn Houben, Erica M Howes, Elissa Jelalian, Natalie B Lister, Mara Cristina Lofrano-Prado, Corby Martin, Anne McTiernan, Janell Mensinger, Tiffany Naets, Dasha Nicholls, Carly Pacanowski, Stephanie Partridge, Wagner L Prado, Sofia Marques Ramalho, Jaythani Raman, Hollie A Raynor, Kyung E Rhee, Elizabeth Rieger, Eric Robinson, Amanda Sainsbury, Vera Salvo, Brian M Shelley, Nancy E Sherwood, Sharon A Simpson, Hanna F Skjakodegard, Evelyn Smith, Yngvild Sørebø Danielsen, Richard I Stein, Marian Tanofsky-Kraff, Rachael W Taylor, Annelies Van Eyck, Krista A Varady, Alaina P Vidmar, Victoria Whitelock, Denise E Wilfley, Jack A Yanovski

Affiliations

¹ Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales, Australia.
² Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.
³ College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
⁴ National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
⁵ Department of Child and Adolescent Psychiatry, University Medical Centre Rostock, Rostock, Germany.
⁶ German Center for Child and Adolescent Health (DZKJ), Partner Site Greifswald/Rostock, Rostock, Germany.
⁷ MRC Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK.
⁸ The Children's Hospital at Westmead, Weight Management Services, Westmead, New South Wales, Australia.
⁹ Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
¹⁰ The Children's Hospital at Westmead, Kids Research, Westmead, New South Wales, Australia.
¹¹ School of Medicine, University of Leeds, Leeds, UK.
¹² InsideOut Institute for Eating Disorders, The University of Sydney, Camperdown, New South Wales, Australia.
¹³ Imperial College London, Division of Psychiatry, National Institute for Health Research, Applied Research Collaboration, London, UK.
¹⁴ School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
¹⁵ School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
¹⁶ Campbelltown and Camden Hospitals, Campbelltown, New South Wales, Australia.
¹⁷ School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
¹⁸ School of Medicine, Washington University in St. Louis, St Louis, Missouri, USA.
¹⁹ The Weight Issues Network, Sydney, New South Wales, Australia.
²⁰ Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA.
²¹ WeightWatchers International, Inc., New York, New York, USA.
²² ConscienHealth, Pittsburgh, Pennsylvania, USA.
²³ Institute of Nursing and Health Research, Ulster University, Newtownabbey, Co. Antrim, UK.
²⁴ College of Psychology, Nova Southeastern University, Davie, Florida, USA.
²⁵ Fit Minded Inc., Phoenix, Arizona, USA.
²⁶ Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, USA.
²⁷ Department of Nutrition, Dietetics & Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Notting Hill, Victoria, Australia.
²⁸ Department of Pediatrics, University of California San Diego, San Diego, California, USA.
²⁹ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
³⁰ Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA.
³¹ Department of Pediatrics, Jacobs School of Medicine, and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
³² Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
³³ Department of Psychology & Kinesiology, California State University, San Bernardino, California, USA.
³⁴ Department of Health Care, Odisee University of Applied Sciences, Nutrition and Dietetics, Ghent, Belgium.
³⁵ Department of Kinesiology, California State University, San Bernardino, California, USA.
³⁶ Children and Youth Clinic, Haukeland University Hospital, Bergen, Vestland, Norway.
³⁷ Counseling on Eating Disorders, ROS, Bergen, Vestland, Norway.
³⁸ Department of Clinical Psychology, University of Bergen, Bergen, Vestland, Norway.
³⁹ Regional Department of Eating Disorders, Haukeland University Hospital, Bergen, Vestland, Norway.
⁴⁰ Department of Medical and Clinical Psychology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
⁴¹ Section on Growth and Obesity, Division of Intramural Research, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
⁴² Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Antwerp, Belgium.
⁴³ Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium.
⁴⁴ Children's Hospital Los Angeles and Keck School of Medicine, Department of Pediatrics, University of Southern California, California, Los Angeles, USA.
⁴⁵ Center for Endocrinology, Diabetes and Metabolism, California, Los Angeles, USA.

PMID: 41367220
PMCID: PMC12690354
DOI: 10.1111/ijpo.70074

Components of Adolescent Behavioural Interventions With Eating Disorder Outcomes: Systematic Review With Intervention Mapping

Natalie B Lister et al. Pediatr Obes. 2026 Jan.

. 2026 Jan;21(1):e70074.

doi: 10.1111/ijpo.70074.

Authors

Collaborators

EDIT Collaboration:
Natalie B Lister, Hiba Jebeile, Anna L Seidler, Brittany J Johnson, Rabia Khalid, Hannah Melville, Sol Libesman, Ruth Tredinnick, Samantha Pryde, Caitlin M McMaster, Kylie E Hunter, Isabelle R Jardine, Sasha J Lorien, Amy L Ahern, Lisa Askie, Louise A Baur, Caroline Braet, Kelly Cooper, Genevieve Dammery, Sarah P Garnett, Rebecca Golley, Alicia M Grunseit, Faith Anne N Heeren, Andrew J Hill, Rebecca A Jones, Theodore K Kyle, Sarah Maguire, Dasha Nicholls, Susan J Paxton, Milan K Piya, Fiona Quigley, Molly Robbins, Amanda Sainsbury, Katharine Steinbeck, Denise E Wilfley, Jacqlyn Yourell, Rachel D Barnes, Melanie K Bean, Kristine Beaulieu, Maxine P Bonham, Kerri N Boutelle, Caroline Braet, Braulio Branco, Simona Calugi, Michelle I Cardel, Kelly M Carpenter, Hoi Lun Cheng, Riccardo Dalle Grave, Katherine E Darling, Brenda Davy, Marcelo Demarzo, Aimee L Dordevic, Dawn M Eichen, Leonard H Epstein, Andrea B Goldschmidt, Amy Gross, Faith Anne N Heeren, Anja Hilbert, Katrijn Houben, Erica M Howes, Elissa Jelalian, Natalie B Lister, Mara Cristina Lofrano-Prado, Corby Martin, Anne McTiernan, Janell Mensinger, Tiffany Naets, Dasha Nicholls, Carly Pacanowski, Stephanie Partridge, Wagner L Prado, Sofia Marques Ramalho, Jaythani Raman, Hollie A Raynor, Kyung E Rhee, Elizabeth Rieger, Eric Robinson, Amanda Sainsbury, Vera Salvo, Brian M Shelley, Nancy E Sherwood, Sharon A Simpson, Hanna F Skjakodegard, Evelyn Smith, Yngvild Sørebø Danielsen, Richard I Stein, Marian Tanofsky-Kraff, Rachael W Taylor, Annelies Van Eyck, Krista A Varady, Alaina P Vidmar, Victoria Whitelock, Denise E Wilfley, Jack A Yanovski

Affiliations

¹ Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales, Australia.
² Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.
³ College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
⁴ National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
⁵ Department of Child and Adolescent Psychiatry, University Medical Centre Rostock, Rostock, Germany.
⁶ German Center for Child and Adolescent Health (DZKJ), Partner Site Greifswald/Rostock, Rostock, Germany.
⁷ MRC Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK.
⁸ The Children's Hospital at Westmead, Weight Management Services, Westmead, New South Wales, Australia.
⁹ Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
¹⁰ The Children's Hospital at Westmead, Kids Research, Westmead, New South Wales, Australia.
¹¹ School of Medicine, University of Leeds, Leeds, UK.
¹² InsideOut Institute for Eating Disorders, The University of Sydney, Camperdown, New South Wales, Australia.
¹³ Imperial College London, Division of Psychiatry, National Institute for Health Research, Applied Research Collaboration, London, UK.
¹⁴ School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
¹⁵ School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
¹⁶ Campbelltown and Camden Hospitals, Campbelltown, New South Wales, Australia.
¹⁷ School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
¹⁸ School of Medicine, Washington University in St. Louis, St Louis, Missouri, USA.
¹⁹ The Weight Issues Network, Sydney, New South Wales, Australia.
²⁰ Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA.
²¹ WeightWatchers International, Inc., New York, New York, USA.
²² ConscienHealth, Pittsburgh, Pennsylvania, USA.
²³ Institute of Nursing and Health Research, Ulster University, Newtownabbey, Co. Antrim, UK.
²⁴ College of Psychology, Nova Southeastern University, Davie, Florida, USA.
²⁵ Fit Minded Inc., Phoenix, Arizona, USA.
²⁶ Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, USA.
²⁷ Department of Nutrition, Dietetics & Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Notting Hill, Victoria, Australia.
²⁸ Department of Pediatrics, University of California San Diego, San Diego, California, USA.
²⁹ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
³⁰ Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA.
³¹ Department of Pediatrics, Jacobs School of Medicine, and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
³² Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
³³ Department of Psychology & Kinesiology, California State University, San Bernardino, California, USA.
³⁴ Department of Health Care, Odisee University of Applied Sciences, Nutrition and Dietetics, Ghent, Belgium.
³⁵ Department of Kinesiology, California State University, San Bernardino, California, USA.
³⁶ Children and Youth Clinic, Haukeland University Hospital, Bergen, Vestland, Norway.
³⁷ Counseling on Eating Disorders, ROS, Bergen, Vestland, Norway.
³⁸ Department of Clinical Psychology, University of Bergen, Bergen, Vestland, Norway.
³⁹ Regional Department of Eating Disorders, Haukeland University Hospital, Bergen, Vestland, Norway.
⁴⁰ Department of Medical and Clinical Psychology, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
⁴¹ Section on Growth and Obesity, Division of Intramural Research, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
⁴² Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Antwerp, Belgium.
⁴³ Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium.
⁴⁴ Children's Hospital Los Angeles and Keck School of Medicine, Department of Pediatrics, University of Southern California, California, Los Angeles, USA.
⁴⁵ Center for Endocrinology, Diabetes and Metabolism, California, Los Angeles, USA.

PMID: 41367220
PMCID: PMC12690354
DOI: 10.1111/ijpo.70074

Abstract

Objective: To understand delivery features and intervention strategies of adolescent weight management interventions which may influence eating disorder risk.

Methods: Systematic searches in four databases and two trial registries to identify randomised controlled trials in adolescents with overweight/obesity measuring eating disorder risk pre- and post-intervention. Delivery features and intervention strategies were coded from published descriptions using a project-specific codebook, validated by trial investigators and narratively synthesised.

Results: Of 11 860 records screened, 23 trials, with 54 intervention arms, were included in the analysis. Most interventions focused on weight loss and maintenance (54%) and were informed by a cognitive behavioural framework (43%). Interventions commonly targeted an individual with a support person (70%). Median intervention duration was 26 weeks, with weekly (35%) or staged (e.g., weekly, then monthly) visit (41%) frequency. Interventions had a mean (SD) of 30 (16.1) intervention strategies. Most included healthy eating education (89%), physical activity education (89%) and problem-solving barriers to dietary change (80%). Few included mental health strategies (17%). Interventions included 'dietary prescription' (65%), and 78% promoted 'healthful/helpful eating behaviours'.

Conclusion: Weight management interventions are complex and vary in delivery approach and strategies used to change behaviors. Characterising interventions is a critical first step to understanding how weight management interventions' influence eating disorder risk.

Keywords: behaviour change techniques; disordered eating; obesity; obesity treatment; overweight.

PubMed Disclaimer

Conflict of interest statement

N.B.L., R.K., I.R.J., S.P., H.M., A.L.S, K.E.H., C.B., S.P.G., S.M., D.N., S.J.P., K.S., K.C., G.D., A.M.G., F.Q., M.R., J.Y., M.K.B., M.P.B., K.N.B., K.E.D., D.M.E., L.H.E., A.B.G., E.J., M.C.L.‐P., T.N., W.L.P., R.I.S., M.T.‐K., A.V.E., B.J.J., H.J. declare no conflicts of interest. A.L.A. is on the Scientific Advisory Board for WW and chairs a Trial Steering Committee for Menwell Ltd. L.A.B. is immediate Past‐President (2022–2024) of the World Obesity Federation, an honorary, unpaid position. She has received honoraria for speaking in forums organised by Novo Nordisk (NN) in relation to management of adolescent obesity (funds directed to research cost centre). L.A.B. is the Australian lead of the study—ACTION Teens: sponsored by NN (multi‐country on‐line study of attitudes towards and perceptions of obesity held by adolescents living with obesity, their parents and health care professionals). L.A.B. has received honoraria (funds directed to hospital research cost centre) for being a member of the Lilly Weight Management Advisory Board. A.J.H. has received payment for advice given to Slimming World (UK). M.K.P. has received travel and consulting fees for speaking and advisory boards from Novo Nordisk, Eli Lilly, Johnson and Johnson Medical Pty Ltd, Takeda Pharmaceuticals and iNova Pharmaceuticals. He was on the guideline development committee for the National Eating Disorder Collaboration ‘Management of eating disorders for people with higher weight: clinical practice guideline (2022)’ and is Vice President of the Australia and New Zealand Obesity Society (ANZOS). A.S. owns 50% of the shares in Zuman International Pty Ltd, which receives royalties and other payments for educational resources and services in adult weight management and research methodology. F.A.N.H. reports serving on the Obesity Society's Finance Committee, consulting fees from WW, an honorarium for speaking from the American Academy of Pediatrics, institutional support to travel and membership on the Obesity Action Coalition's Membership and Access to Care Committees, outside the scope of the submitted work. R.A.J. is an employee and shareholder of WeightWatchers International (WW). T.K.K. has received professional fees from Novo Nordisk, Nutrisystem, Emerald Lake Safety, Roman Health Ventures and Boehringer Ingelheim. M.I.C. is an employee and shareholder of WW International Inc. A.L.D. has an honorary, unpaid position at Nutrition Society of Australia as Honorary Secretary and Director of the Board from 2024. H.F.S. previously received salary from Novo Nordisk unrelated to the present work. Y.S.D. received a one‐time payment from NovoNordisk for creating information materials about eating disorders for health care professionals. Y.S.D. is part of the steering group of the E‐BATTLE Obesity trial a placebo‐controlled RCT testing semaglutide in the treatment of severe obesity in adolescents (starting in 2025). Medications and placebo‐medications are provided by Novo Nordisk but not funding for the study. A.P.V. has received consulting fees from Rhythm Pharmaceuticals and Soleno Pharmaceuticals. J.A.Y. reports unrelated grant funds to NICHD supporting his clinical research from Soleno Therapeutics, Rhythm Pharmaceuticals and Hikma Pharmaceuticals and materials from Versanis Bio to support mouse studies.

Figures

**FIGURE 2**
Frequency of intervention strategies across and within intervention arms. Each row represents an intervention arm arranged by year of the corresponding trial, starting from the oldest trial at the top down to the most recent trial (based on recruitment date, or publication date if unavailable). Each column represents clusters of intervention strategies within five broad categories; each number in brackets reports the number of strategies within that cluster. The colors of each square depict the proportion of total intervention strategies within that strategy cluster that are used in the intervention arm.

**FIGURE 3**
Frequency of individual and combinations of intervention strategy clusters across all interventions. Circles represent clusters of intervention strategy clusters with circle colours corresponding to category levels. Frequency of intervention strategy clusters is reflected by circle sizes with larger circles representing more common strategy clusters. Combinations and frequency strategy clusters are reflected by line width and connections, with thicker lines representing more common combinations.

See this image and copyright information in PMC

References

1. Hampl S. E., Hassink S. G., Skinner A. C., et al., “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity,” Pediatrics 151, no. 2 (2023): e2022060640, 10.1542/peds.2022-060640. - DOI - PubMed
1. Lister N. B., Baur L. A., Felix J. F., et al., “Child and Adolescent Obesity,” Nature Reviews Disease Primers 9, no. 1 (2023): 24, 10.1038/s41572-023-00435-4. - DOI - PubMed
1. Al‐shoaibi A. A. A., Lavender J. M., Kim S. J., et al., “Association of Body Mass Index With Progression From Binge‐Eating Behavior Into Binge‐Eating Disorder Among Adolescents in the United States: A Prospective Analysis of Pooled Data,” Appetite 200 (2024): 107419, 10.1016/j.appet.2024.107419. - DOI - PMC - PubMed
1. Khalid R., Lister N. B., Paxton S. J., et al., “Potential Pathways to the Onset and Development of Eating Disorders in People With Overweight and Obesity: A Scoping Review,” Obesity Reviews 26, no. 1 (2025): e13840, 10.1111/obr.13840. - DOI - PMC - PubMed
1. Lister N. B., Baur L. A., Paxton S. J., and Jebeile H., “Contextualising Eating Disorder Concerns for Paediatric Obesity Treatment,” Current Obesity Reports 10, no. 3 (2021): 322–331, 10.1007/s13679-021-00440-2. - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- PubMed Central
- Wiley
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Components of Adolescent Behavioural Interventions With Eating Disorder Outcomes: Systematic Review With Intervention Mapping

Collaborators

Affiliations

Components of Adolescent Behavioural Interventions With Eating Disorder Outcomes: Systematic Review With Intervention Mapping

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical