Management of adolescent obesity in developing countries: A systematic review

Abstract

Background: Adolescent obesity is a menace that demands a multi-factorial approach to its management and prevention. Aim: The purpose of this review was to assess interventions used in the management of adolescent obesity in developing countries. Methods: Electronic search were conducted between January 2000 and December 2022 on six databases: Pubmed, GoogleScholar, CINAHL, SCOPUS, Cochrane Library and Science Direct and three clinical trial registries: Pan African Clinical Trial, World Health Organization and clinicalTrial.gov. The quality of the included studies was assessed using the Effective Public Health Practice Project. Results: Eighteen studies met the inclusion criteria. The studies were conducted in Africa (N = 7), Asia (N = 6) and South America (N = 5). The sample size ranged from 10 to 4003 at baseline. The studies were carried out in schools (N = 13) and hospitals (N = 5) with four main varied designs: controlled trial (N = 7), quasi-experimental (N = 3), cohort (N = 3) and longitudinal (N = 4). The duration of the interventions ranged from six weeks to three years. The interventions were nutrition education (NE) and physical education (PE) (N = 11), PE only (N = 3), Surgery/NE (N = 1), Surgery/NE/PE (N = 1) and psychotherapy/NE/PE (N = 2). Three studies that used NE and PE and five studies that used same reported significant differences in body mass index for-age z score (zBMI) and waist circumference, respectively. Studies that included surgeries in the interventions reported significant differences in weight, zBMI and waist-to-hip ratio. Conclusions: Few intervention studies have been done on management of adolescent obesity in developing countries and largely effective. All interventions prioritized nutrition and/or PE. The studies were largely school-based.