• Intervention
    How does adolescent-only treatment of obesity compare to interventions with both adolescents and their parents (separately)?
    • Conclusion

      There is insufficient evidence to determine whether targeting parents and adolescents separately to treat childhood obesity works any better than targeting only the adolescents.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In adolescents, what balanced macronutrient dietary interventions are effective in treating obesity?
    • Conclusion

      Using a reduced-calorie diet (over 1,200-DRI kcal per day) in the acute treatment phase of adolescent obesity is generally effective for short-term improvement in weight status. However, without continuing intervention, weight is regained.

      All the studies reviewed had treatment programs lasting less than one year (three weeks to nine months) and evidence on longer-term treatment trials was not available.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the effectiveness of family-based counseling including parent training or modeling as part of a multicomponent pediatric weight management program to treat obesity in adolescents (ages 13-18)?
    • Conclusion

      Including parent training or modeling as part of a multicomponent program to treat adolescent obesity is associated with improvement in adiposity.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Behavioral Interventions for Pediatric Weight Management 2005
       
    What is the effectiveness of using a prescribed dietary plan as part of an intervention program for adolescent (ages 13-18) obesity?
    • Conclusion

      Including a prescribed diet plan as part of a multi-component weight management program results in improvements in adiposity in adolescents in both the short-term and longer-term (more than one year).

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: PWM: Treatment Format: Prescribed Diet Plan 2003
       
    What is the effectiveness of using nutrition education without a prescribed diet plan as the dietary component of a multicomponent pediatric weight management program in adolescents (ages 13-18)?
    • Conclusion

      In adolescents (ages 13-18), using nutrition education alone (without some form of individualized diet plan with the child or child and family) as part of a multicomponent weight management program is associated with short term and longer term (>1 year) improvement in adiposity measures.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: PWM: Treatment Format: Prescribed Diet Plan 2003
       
    What is the effectiveness of using peer modeling as a part of a multicomponent pediatric weight management program to treat obesity in adolescents?
    • Conclusion

      Using peer-modeling groups as part of a multi-component pediatric weight-management program may result in significant reductions in weight status and adiposity in adolescents.

    • Grade: IV
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Treatment Format: Peer Modeling to Treat Childhood Overweight 2006
       
    What is the evidence to support using an ad libitum, low carbohydrate diet as a way of treating obesity in adolescents?
    • Conclusion

      An ad libitum, low-carbohydrate diet may be effective in reducing adiposity in the short-term among adolescents.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    How does adolescent-only treatment of obesity compare to interventions with both adolescents and their parents (together)?
    • Conclusion

      Studies directly comparing parent-and-adolescent together vs. adolescent-only obesity treatment formats are inconsistent in their findings about the different effects of these two treatment formats. Thus, there is insufficient evidence to determine whether one treatment format is better than the other in bringing about weight loss outcomes.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the effectiveness of family-based counseling as a part of an intervention program to treat obesity in adolescents (ages 13-18)?
    • Conclusion

      Inclusion of family counseling as part of a multi-component adolescent weight-management program may provide beneficial effects. However, definite conclusions are hampered by the fact that evidence is limited to a small number of older studies, studies of weak design and inconsistent results.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    How does treatment of adolescent obesity by interventions with parents and adolescents together compare to interventions with parents and adolescents separate?
    • Conclusion

      There is not enough research to be able to determine whether treating adolescent obesity by treating parents and adolescents together may be better or worse than treating them separately. It is possible that neither treatment format is preferable to a format that includes parents and adolescents together for some aspects of treatment, while keeping them separate for other aspects of treatment.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    Is counseling of adolescents for weight loss in the absence of their parents effective?
    • Conclusion

      Counseling adolescent children (13 to 18 years) for weight loss in the absence of some form of parent participation may be effective in the short-term and perhaps for as long as one year post-treatment.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the evidence that interventions targeting only parents may contribute to the effective treatment of obesity in adolescents?
    • Conclusion

      There is insufficient evidence to determine whether targeting only parents as a way to address obesity among adolescents is more effective than targeting adolescents only.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Treatment Format: Targeting Parents Only for Pediatric Overweight 2004