title: Weight loss in children and adolescents.
abstract: BACKGROUND
  15% of children and adolescents in Germany are overweight, including 6.3% who are affected by obesity. The efficacy of conservative weight-loss treatments has been demonstrated, but there has not yet been a detailed analysis of their efficacy in terms of the amount of weight loss that can be expected. We re-evaluated the available evidence on this question, with particular attention to the methodological quality of clinical trials, in order to derive information that might be a useful guide for treatment.
  
  
  METHODS
  We conducted a systematic literature search of Medline for the period May 2008 (final inclusion date for a 2009 Cochrane Review) to December 2013. The identified studies were analyzed qualitatively.
  
  
  RESULTS
  48 randomized controlled clinical trials with a total of 5025 participants met the predefined inclusion criteria for this analysis. In the ones that met predefined criteria for methodological quality, conservative weight-loss treatments led to weight loss in amounts ranging from 0.05 to 0.42 BMI z score (standard deviation score of the body mass index) over a period of 12-24 months. Information on trial dropout rates was available for 41 of the 48 trials; the dropout rate was 10% or higher in 27 of these (66% ), and 25% or higher in 9 (22% ).
  
  
  CONCLUSIONS
  The available evidence consistently shows that only a modest degree of weight loss can be expected from conservative treatment. Families seeking treatment should be informed of this fact. Future research should focus on determining predictive factors for therapeutic benefit, and on the evaluation of additional types of psychological intervention to promote coping with obesity.
authors.affiliation: Department of Child and Adolescent Psychiatry, LVR-Klinikum Essen, University of Duisburg-Essen, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology, Diabetes and Obesity Unit, University of Ulm.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Mühlig
authors.forename: Martin
authors.initials: M
authors.lastname: Wabitsch
authors.forename: Anja
authors.initials: A
authors.lastname: Moss
authors.forename: Johannes
authors.initials: J
authors.lastname: Hebebrand
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D002908:Chronic Disease; D004035:Diet Therapy / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome; D061217:Weight Reduction Programs / Q000706:statistics & numerical data*