Obesity in children.

INTRODUCTION: Obesity is the result of long-term energy imbalances, where daily energy intake exceeds daily energy expenditure. Along with long-term health problems, obesity in children may also be associated with psychosocial problems, including social marginalisation, low self-esteem, and impaired quality of life. Most obese adolescents stay obese as adults. Obesity is increasing among children and adolescents, with 16.8% of boys and 15.2% of girls in the UK aged 2 to 15 years obese in 2008. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of lifestyle interventions for the treatment of childhood obesity? What are the effects of surgical interventions for the treatment of childhood obesity? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 14 systematic reviews and RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following lifestyle interventions: behavioural, diet, and multifactorial interventions; physical activity; and bariatric surgery.