Poster Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

Childhood obesity, weight management and depression: a systematic review and meta-analysis (#318)

Hiba Jebeile 1 2 , Megan L Gow 1 2 , Susan Paxton 3 , Katharine Aldwell 2 , Sarah Thomas 2 , Sarah P Garnett 1 2 , Louise A Baur 1 2 , Natalie B Lister 1 2
  1. Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
  2. Institute of Endocrinology and Diabetes, and Weight Management Services, The Children’s Hospital at Westmead, Westmead, NSW, Australia
  3. School of Psychology and Public Health, La Trobe University , Melbourne, Victoria, Australia

Introduction: Child and adolescent overweight and obesity is associated with depression, and may contribute to increased depression into adulthood. The aim of this systematic review and meta-analysis was to investigate the impact of weight management interventions on depression in children and adolescents with overweight or obesity.

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

Results: Of 2799 articles screened, 29 studies (n=1542, 9.5-16.5 years) met the inclusion criteria. Meta-analyses showed reduced levels of depression post-intervention (one week to 15 months, standardised mean difference, SMD [SE] = -0.47 [0.077], p<0.001), which was maintained at follow-up (6-16 months, six studies, -0.528 [0.21], p=0.011). However, the absolute reduction was small (-2.8 points on a scale of 0-54) and may not be clinically significant. BMI z-score was reduced post-intervention (11 studies, mean difference [SE] = -0.183 [0.014], p<0.001) and at follow-up (four studies, -0.261 (0.022), p<0.001). Interestingly, change in depression did not differ between studies using an energy prescription (SMD [SE] -0.511 [0.21], p=0.015) compared to healthy eating education (-0.452 [0.068], p<0.001). Interventions with structured exercise classes had the highest effect size (-0.533 [0.107], p<0.001), followed by interventions providing physical activity education (-0.388 [0.092], p<0.001). Interventions which did not report incorporating or encouraging physical activity did not significantly change depression symptoms (-0.137 [0.14], p=0.335).

Conclusion: Engagement in weight management interventions did not worsen depressive symptoms. In fact, weight management may lead to mild improvements and disrupt the progression of depression in children and adolescents with overweight or obesity. Inclusion of physical activity within treatment appears to be important.