Digital Health Interventions for Weight Management in Children and Adolescents: Systematic Review and Meta-analysis

Abstract

Background Recent meta-analyses suggest the use of technology-based interventions as a treatment option for obesity in adulthood. Similar meta-analytic approaches for children are scarce. Objective The aim of this meta-analysis is to examine the effect of technology-based interventions on overweight and obesity treatment in children and adolescents. Methods A systematic literature search was performed using MEDLINE (PubMed), Scopus, and Cochrane Library for randomized clinical trials to identify interventional studies published between January 2000 and February 2021. Results In total, 9 manuscripts from 8 clinical trials of 582 children or adolescents were considered eligible. BMI, BMI z-score, and other BMI-related baseline metrics during and after intervention were considered as primary outcomes. In 7 of 8 studies, a technology-based intervention was applied in addition to conventional care. Of the 8 studies, 6 studies were conducted in the United States, 1 in Australia, and 1 in northwestern Europe. In total, 5 studies included adolescents, whereas the rest addressed children aged 9 to 12 years. Intervention duration ranged from 3 to 24 months. Significant differences between groups in BMI metric changes were reported by 5 of the 8 studies. Pooled analysis revealed an overall significant decrease in BMI metrics in the intervention group (standardized mean difference –0.61, 95% CI –1.10 to –0.13; P=.01). Subgroup analysis revealed that significance was lost in case of no parental involvement (standardized mean difference –0.36, 95% CI –0.83 to 0.11; P=.14). The small number of clinical trials found, the varying study quality, and the study heterogeneity are some limitations of this review. Conclusions The studies reported herein describe functional and acceptable technology-based approaches, in addition to conventional treatments, to enhance weight loss in young populations.