A review of the effectiveness of interdisciplinary services for the treatment of overweight and obese children in the community

The alarming rise in the prevalence of childhood obesity in recent years justifies an interest in evaluating the effectiveness of treatment interventions in the primary care setting, where they can be more accessible to the general population. This review aims to evaluate the effectiveness multidisciplinary team interventions in this setting, in view of increasing recognition of the important role that such teams play in the treatment of childhood obesity. A search of the Pubmed database was carried out based on pre-established inclusion and exclusion criteria. 26 studies from 18 different journals were included in the review, these being mainly behavioural, parenting and lifestyle interventions or combinations thereof. 18 of the studies reviewed reported on interventions that led to statistically significant changes in waist circumference, BMI or BMI-derived scores such as BMI percentiles and BMI z-scores. Assessing the clinical significance of the reported changes presented difficulties due to lack of explicit reporting of clinical significance and lack of widely-accepted weight-loss goals for such interventions in children. The most successful interventions tended to feature standardized training of professional staff in the intervention and use of tailored educational material. While the exact formulation of the multidisciplinary team varied, the teams regularly feature professionals trained in the fields of nutrition, physical education/exercise therapy and psychology and often did not involve doctors beyond the participant referral stage. Low-intensity interventions where contact was made on a one-off, 3-6 monthly or monthly basis were generally ineffective.