Pediatric weight management, dietary restraint, dieting, and eating disorder risk: a systematic review

Eve T House; Megan L Gow; Natalie B Lister; Louise A Baur; Sarah P Garnett; Susan J Paxton; Hiba Jebeile

doi:10.1093/nutrit/nuaa127

Pediatric weight management, dietary restraint, dieting, and eating disorder risk: a systematic review

Nutr Rev. 2021 Sep 7;79(10):1114-1133. doi: 10.1093/nutrit/nuaa127.

Authors

Eve T House^{1

2}, Megan L Gow^{1

2}, Natalie B Lister^{1

2}, Louise A Baur^{1

3}, Sarah P Garnett^{1

2}, Susan J Paxton⁴, Hiba Jebeile^{1

2}

Affiliations

¹ The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.
² Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
³ Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
⁴ School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.

PMID: 33608718
DOI: 10.1093/nutrit/nuaa127

Abstract

Context: Whether dietary restraint and dieting are risk factors associated with eating disorders has not been explored in the context of pediatric weight management.

Objective: To review associations between dietary pediatric weight management, dietary restraint, dieting, and eating disorder risk.

Data sources, selection, and extraction: Four databases - MEDLINE, EMBASE, Cochrane Library, and PsycINFO - were searched to May 2020 to identify pediatric weight management interventions with a dietary component for children and adolescents with overweight or obesity. The review was limited to studies reporting dietary restraint and/or dieting at preintervention, postintervention, and/or follow-up. Screening and quality assessment were conducted in duplicate, and data extraction was completed by 1 reviewer and cross-checked for accuracy. Data extracted included study characteristics, dietary restraint/dieting, and eating disorder-related outcomes (including disordered eating, body image, self-esteem, depression, and anxiety).

Results: A total of 26 papers, representing 23 studies, were included. Of these, 20 studies reported on dietary restraint, which increased (10 postintervention, 6 follow-up) or remained unchanged (7 postintervention, 5 follow-up), and 5 studies reported on dieting, which increased (1 study), remained unchanged (2 studies) or decreased (2 studies) postintervention. All studies that reported on other eating disorder risk factors (eg, binge eating, body dissatisfaction, and depression) and weight-related outcomes found improvement or no change postintervention or at follow-up.

Conclusion: The results of this review suggest that current measures of dietary restraint and dieting are not associated with eating disorder risk within the context of pediatric weight management; however, long-term data is limited. In addition, those current measures may not be suitable risk markers. Concerns about dietary restraint and dieting leading to eating disorders should not prevent access to quality care for young people with obesity.

Systematic review registration: PROSPERO registration no. 2017 CRD42017069488.

Keywords: adolescent; child; dietary restraint; dieting; disordered eating; pediatrics; weight management.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Adolescent
Body Weight Maintenance* / physiology
Caloric Restriction* / statistics & numerical data
Child
Diet / statistics & numerical data
Feeding Behavior*
Feeding and Eating Disorders* / epidemiology
Humans
Obesity / prevention & control
Overweight / prevention & control
Risk Factors