The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta-analysis

Introduction: Behavioral weight management interventions (BWMIs) are an evidence-based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study describes a systematic review and meta-analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity. Methods: Seven databases were searched, and eligible studies included randomized controlled trials reporting EBT outcomes following BWMIs delivered to children with overweight or obesity (<18 years of age). Random effects meta-analyses were conducted to compare EBT outcomes for intervention and control groups. Synthesis without meta-analysis (SWiM) was applied for EBTs where meta-analysis was not feasible. Results: The review identified eight trials characterizing the impact of BWMIs on 15 EBTs. Meta-analyses of data from three trials at intervention completion and post-intervention (average of 28 weeks [+/- 8]) revealed positive short-term increases in dietary restraint (SMD random effect 0.42 [95% CI 0.13, 0.70]). However, these effects were not sustained at follow-up. Improvements in emotional eating, external eating, food responsiveness, and enjoyment of food were shown in studies which could not be pooled quantitatively. Conclusion: BWMIs in children living with overweight/obesity are beneficial for the improvement of some EBTs at intervention completion including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food. However, this remains a relatively unexplored area and more research is needed to strengthen understanding of the multifaceted impact of child BWMIs on a comprehensive range of EBTs.