Systematic review of the efficacy of yoga and mindfulness in the management of pediatric obesity

The neuroplasticity of adolescents could make them responsive to interventions affecting brain maturation such as yoga and mindfulness. We aimed to determine their efficacy and safety for the management of children and adolescents with obesity. A systematic search using MEDLINE, EMBASE, and PsycInfo was performed up to March 2024. We considered randomized controlled trials (RCTs) using yoga or mindfulness alone (or combined with standard therapy) compared to placebo, nothing, or standard therapy for weight loss. Methodological quality of studies was assessed with the Risk of Bias 2 tool. The primary outcomes were changes in weight and adiposity (kg, body mass index [BMI], BMI z‐score, fat mass, waist circumference, waist‐to‐hip ratio). We assessed 4 yoga and 7 mindfulness RCTs, including 620 participants 8–19 years old. The number of participants varied per type of intervention (yoga, n = 10–63; mindfulness, n = 11–47). Comparators were no‐intervention or active controls. All yoga trials reported anthropometric improvements, but all trials combined yoga with extra physical activity. Five out of seven mindfulness trials reported anthropometric improvements. The methodological quality of the RCTs was low. No safety information was reported. The effect of yoga and mindfulness on psychological and metabolic variables was inconsistent. This evidence is insufficient to recommend yoga or mindfulness for the management of adolescents with obesity. The neuroplasticity of adolescents could make them responsive to interventions affecting brain maturation. Meditation‐based interventions like yoga and mindfulness appear to influence brain maturation processes. Yoga and mindfulness use meditation but have differences that might impact the weight of individuals with obesity through different mechanisms. Although yoga might have an impact via meditation and increased energy expenditure, mindfulness probably does so through meditation and modulating stress, anxiety, and appetite signals.