RESUMO
BACKGROUND: Obesity in the United States has been identified as one of the most prevalent health epidemics affecting both adults and children, and it has become the focus of a variety of primary, secondary, and tertiary healthcare interventions. OBJECTIVES: To summarize and assess the efficacy of current practices in the management and treatment of pediatric overweight and obesity. METHODS: An extensive review of the literature was performed. This review examined five areas of intervention most commonly used to manage and treat pediatric overweight and obesity: physical activity, nutritional and behavioral interventions, pharmaceutical management, and surgical procedures. RESULTS: Of 82 sources, 43 studies met our inclusion and exclusion criteria. However, after evaluating study strength using the PEDro, 24 were included in this systematic review. The studies, which included RCTs and cohort studies of levels I and II evidence, respectively, were evaluated for methodological quality using the PEDro scale. Programs that combined decreased sedentary behaviors and nutritional modifications had the most significant results in changes in body mass index (BMI) and weight gain or weight loss. CONCLUSION: To ensure successful management and treatment of pediatric obesity, the most successful paradigm of intervention is through a multidisciplinary approach: physical activity, nutrition, and behavioral strategies. Behavioral interventions should support and reinforce physical activity and nutritional modifications. Because of the potential health risks involved to the child, pharmaceutical and surgical approaches are considered only when all other interventions have failed.
