Weight-neutral interventions in young people with overweight or obesity: A systematic review

摘要

Background: Weight-neutral approaches are an emerging area of dietetic practice in adults. Their utility in young people with overweight/obesity is unknown. Aim: To describe findings from weight-neutral interventions in treatment-seeking young people (10 to 24 years) with overweight/obesity. Methods: Six databases were searched to October 2019, studies were eligible if weight loss was not the intention of the intervention and included young people above healthy weight. Results: Six articles met inclusion criteria, representing three pilot studies. Study 1 (n = 37, 14-17y) compared a 6-week mindful eating program with a single lifestyle education session; Study 2 (n = 35, 14-17y), 12-week non-diet lifestyle education program with/without guided imagery to promote health behaviours; and Study 3 (n = 33, 12-17y), 6-week mindfulness intervention compared with cognitive-behavioural depression prevention in adolescents at risk of type 2 diabetes with depressive symptoms. All studies reported weight-neutral interventions were acceptable. Study 1 and 3 reported no change in mindfulness. Study 2 found intuitive eating (Hawks' Scale) had a greater increase post-intervention in the non-diet plus guided imagery group (0.32 ± 0.36, P < 0.05), compared with the non-diet alone (0.15 ± 0.29). Study 1 reported BMI decreased (P < 0.001) post-intervention following mindful eating (-1.1 kg/m~2) and increased in the lifestyle group (+0.7 kg/m~2); Study 2 reported no change in BMI; and Study 3 reported BMIz decreased following mindfulness at 1 year follow-up (-0.16), with no difference between groups. Conclusions: Weight-neutral interventions are feasible in adolescents with overweight/obesity, but data are limited. Further research is warranted on the use of weight-neutral interventions for the management of adolescent obesity.