Pediatric obesity treatment, self-esteem, and body image: A systematic review with meta-analysis

Abstract

Background: Pediatric obesity impacts on multiple domains of psychological health, including self-esteem and body image.

Objective: To determine the effect of multicomponent pediatric obesity treatment interventions on self-esteem and body image.

Methods: A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library, and PsychINFO. Eligible studies implemented an obesity treatment intervention, including a dietary and physical activity component with/without a behavioral component, in children and adolescents with overweight/obesity, and assessed self-esteem and/or body image. Data were extracted by one reviewer and cross-checked. Meta-analysis was used to combine outcome data and moderator analysis conducted to identify intervention characteristics influencing outcomes.

Results: 64 studies were identified. Meta-analysis of 49 studies (n = 10471) indicated that pediatric obesity treatment results in increased self-esteem postintervention (standardized mean difference, [SE] 0.34 [0.03], P < .001, I² 87%), maintained at follow-up (0.35 [0.05] P < .001, I² 79%, 17 studies). Similarly, meta-analysis of 40 studies (n = 2729) indicated improvements in body image postintervention (0.40 [0.03], P < .001, I² 73%), maintained at follow-up (0.41 [0.08], P < .001, I² 89%, 16 studies).

Conclusions: Pediatric obesity treatment improves self-esteem and body image in the short and medium term. These findings may underpin improvements in other psychological outcomes.

Keywords: body image; obesity; obesity treatment; self-esteem; systematic review.