Weight-neutral interventions in young people with high body mass index: A systematic review

Johanna K Hoare; Natalie B Lister; Sarah P Garnett; Louise A Baur; Hiba Jebeile

doi:10.1111/1747-0080.12729

Weight-neutral interventions in young people with high body mass index: A systematic review

Nutr Diet. 2023 Feb;80(1):8-20. doi: 10.1111/1747-0080.12729. Epub 2022 Apr 11.

Authors

Johanna K Hoare^{1

2}, Natalie B Lister^{1

2}, Sarah P Garnett^{1

2

3}, Louise A Baur^{1

3

4}, 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 Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
⁴ Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

Abstract

Aim: This systematic review explored the feasibility, acceptability and effect on health outcomes of weight-neutral interventions in health improvement-seeking young people with overweight/obesity.

Methods: Six databases were searched to March 2021 for health, but not weight, focused interventions (PROSPERO, CRD42020152671). Eligible studies recruited young people (10-24 years) with overweight/obesity. The studies were described using narrative synthesis, with numerical results summarised. The quality of included studies was assessed using the Joanna Briggs Institute critical appraisal tools.

Results: Six articles were included, representing three pilot studies. Study 1 (n = 37, 14-17 years) compared a 6-week mindful eating program with single-session lifestyle education; Study 2 (n = 35, 14-17 years) compared 12-week weight-neutral lifestyle education focused on intuitive eating and carbohydrate quality, with/without guided imagery; and Study 3 (n = 33, 12-17 years) compared a 6-week mindfulness intervention with cognitive behavioural therapy in adolescents with depressive symptoms at risk of type 2 diabetes. All interventions explored feasibility (intervention group retention 57%-88%, attendance >80%) and reported interventions were acceptable. Studies 1 and 3 reported no change in mindfulness. Study 2 reported an increase (p < 0.05) in intuitive eating following weight-neutral plus guided imagery (0.32 ± 0.36, Hawks' Scale, score 1-4), compared with weight-neutral alone (0.15 ± 0.29). Study 1 reported decreased body mass index (p < 0.001) following mindful eating (-1.1 kg/m² ), compared with single-session lifestyle education (+0.7 kg/m² ); Studies 2 and 3 found no change in body mass index or body mass index z-score.

Conclusions: Weight-neutral interventions may be feasible and acceptable in adolescents with overweight/obesity in the short term (≤12 weeks), but data are limited.

Keywords: adolescent; body weight; health at every size; mindfulness; obesity; overweight.

Publication types

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

MeSH terms

Adolescent
Body Mass Index
Diabetes Mellitus, Type 2*
Exercise
Humans
Obesity
Overweight* / therapy