Pediatric obesity treatment, self‐esteem, and body image: A systematic review with meta‐analysis

Summary Background Pediatric obesity impacts on multiple domains of psychological health, including self‐esteem and body image. Objective To determine the effect of multicomponent pediatric obesity treatment interventions on self‐esteem and body image. Methods A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library, and PsychINFO. Eligible studies implemented an obesity treatment intervention, including a dietary and physical activity component with/without a behavioral component, in children and adolescents with overweight/obesity, and assessed self‐esteem and/or body image. Data were extracted by one reviewer and cross‐checked. Meta‐analysis was used to combine outcome data and moderator analysis conducted to identify intervention characteristics influencing outcomes. Results 64 studies were identified. Meta‐analysis of 49 studies (n = 10471) indicated that pediatric obesity treatment results in increased self‐esteem postintervention (standardized mean difference, [SE] 0.34 [0.03], P < .001, I2 87%), maintained at follow‐up (0.35 [0.05] P < .001, I2 79%, 17 studies). Similarly, meta‐analysis of 40 studies (n = 2729) indicated improvements in body image postintervention (0.40 [0.03], P < .001, I2 73%), maintained at follow‐up (0.41 [0.08], P < .001, I2 89%, 16 studies). Conclusions Pediatric obesity treatment improves self‐esteem and body image in the short and medium term. These findings may underpin improvements in other psychological outcomes.