Digital Health Interventions May Aid Pediatric Obesity Treatments

Digital health interventions for treatment of overweight and obesity may be beneficial among adolescents and children, although it remains uncertain how these interventions might substitute or supplement elements of multicomponent standard care, according to umbrella review findings published in Obesity Reviews.

To characterize the effects of digital health interventions in management of overweight and obesity among children, investigators conducted a systematic umbrella review of reviews and meta-analyses. Included reviews reported on the use of digital health technology (experiences and/or effectiveness) in management of overweight and obesity among adolescents and children (0 to 19 years of age) with overweight or obesity according to World Health Organization (WHO) criteria.

The umbrella review included a total of 16 reviews and 10 meta-analyses, of which 15 were based primarily on quantitative data from primary studies. Randomized controlled trials (RCTs) only were included in 9 reviews, whereas non-RCTs with or without control arms were included in the remaining 7 reviews. A majority of primary studies in all 16 reviews were conducted in the United States, Europe, or Oceania with poor representation from middle- or low-income countries.

Total participants covered by the reviews ranged from 195 to 5777. In analysis of body mass index (BMI) and BMI-z-scores, small effects on anthropometric measures of all digital interventions were noted (overall Cohen’s d, -0.28; 95% CI, -0.40 to -0.16; P <.001) and corresponded to a small effect size.

In summaries, all review authors noted small positive effects on weight-related metrics, although heterogeneity of interventions and the high number of small studies restricted the strength of evidence.

The investigators noted 5 out of 13 systematic reviews were rated as low quality and 8 out of 13 reviews were rated as critically low quality.

Umbrella review limitations include possible loss of relevant information due to exclusion of summaries reporting on both treatment and prevention, exclusion of some primary studies not aligning with the current review search criteria, and the lack of coverage of risks and needs of underprivileged populations.

“Effects on anthropometric measures of all digital health interventions were small when analyzing BMI and BMI-z-scores combined,” the investigators concluded. “It is currently unclear how different digital health interventions tested to date may supplement or substitute elements of multicomponent standard care treatment for children and adolescents with overweight or obesity.”