Poster Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

Change in self-esteem following paediatric weight management interventions: a systematic review and meta-analysis (#317)

Melissa Su Yi Tee 1 , Natalie Lister 2 3 , Megan L Gow 2 3 , Susan J Paxton 4 , Katharine Aldwell 3 , Sarah Thomas 3 , Sarah Garnett 2 3 , Louise Baur 2 3 , Hiba Jebeile 2 3
  1. Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  2. Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
  3. Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, NSW, Australia
  4. School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia

 

Objective: Children and adolescents with overweight or obesity are likely to have lower self-esteem compared to normal weight peers. Weight management interventions are successful at reducing BMI however, the effect on self-esteem is unclear. This systematic review investigates the impact of weight management interventions in children and adolescents with overweight or obesity on self-esteem.

Methods: Four databases were searched in May 2017 to retrieve peer-reviewed articles that met the following eligibility criteria: (1) children and adolescents with overweight or obesity, aged <18 years, (2) weight management intervention with a nutrition component, (3) case studies, pre-post studies and randomised controlled trials (RCTs), (4) pre- and post-intervention assessment of self-esteem using a validated tool.

Results: Of 2799 articles screened, 40 studies (9.3-15.6 years, n=10131) met the inclusion criteria. Meta-analyses showed a medium positive effect for self-esteem post-intervention (one week to 15 months) (standardised mean difference (SE) = 0.42 [0.05] p<0.001). Sixteen studies had follow-up measurements (2.5 months to 2.4 years post-intervention) which indicated the effect was maintained (0.36 [0.05], p<0.001). However, the effect is unlikely to be clinically significant. Analysis of RCTs (eight studies), supported these findings. Studies with a targeted self-esteem component had a larger effect (0.558 [0.13], p<0.001) than studies with no self-esteem component (0.373 [0.05], p<0.001). Studies which included parental involvement had a larger effect (0.417 [0.05], p<0.001) than studies with no parental involvement (0.365 [0.06], p<0.001). In terms of setting, there was no difference in effect between inpatient programs (0.477 [0.23], p=0.038), outpatient programs (0.452 [0.06], p<0.001) and summer camps (0.440 [0.06], p<0.001), with the smallest effect observed in a community setting (0.319 [0.05], p<0.001).

Conclusion: Engagement in weight management interventions was not associated with a decrease in self-esteem. The inclusion of targeted self-esteem components within weight management may lead to a clinically significant improvement.