[Clinical interventions in overweight and obesity: a systematic literature review 2009-2014].
OBJECTIVE
To update the literature review on the effectiveness of clinical interventions on childhood obesity, proposed in Clinical Practice Guidelines, excluding prevention and pharmacological and surgical treatments.


METHODS
A systematic review was carried out in electronic databases of the Cochrane Database of Systematic Reviews (The Cochrane Library), MEDLINE, and SCOPUS, replicating the search for the Clinical Practice Guidelines, from 2009 to 2014. The Clinical Practice Guidelines of National Institute for Health and Care Excellence were taken as a reference. Systematic reviews were given priority, and the quality of the studies was assessed.


RESULTS
Out of a total of 3,703 documents initially identified, 48 were finally included. Studies showed great heterogeneity in the type and duration of interventions, and in outcome measures. Adherence to treatment was, in general, low. Multi-component interventions including diet, physical activity, sedentary lifestyle, and behaviour changes, involving the family, and starting at early ages, were the most effective for reducing body mass index. There is no consensus on criteria for referral to specialised care.


CONCLUSIONS
It is recommended to implement multi-component programs conducted by professionals with previous training, involving the family, and addressing behavioural, individual and socio-demographic aspects. Lack of adherence is one of the reasons for failure of interventions. Diagnostic and referral criteria, the outcome measures, and the type and duration of interventions need to be improved and standardised.
Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Biomèdiques, Barcelona, España; Centro de Investigación Biomédica en Red, Epidemiología y Salud Pública CIBERESP, Madrid, España. Electronic address: lrajmil@gencat.cat.
Luis
L
Rajmil
Servicio de Pediatria, Hospital Universitario Germans Trias i Pujol, Badalona, España.
Joan
J
Bel
Centro de Atención Primaria Llefià, Institut Català de la Salut (ICS), Badalona, España.
Rosa
R
Clofent
Departament de Salut, Subdirecció de Promoció de la Salut, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, España.
Carmen
C
Cabezas
Departament de Salut, Subdirecció de Promoció de la Salut, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, España.
Conxa
C
Castell
Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Barcelona, España.
Mireia
M
Espallargues
D002648:Child; D006801:Humans; D050177:Overweight / Q000628:therapy*; D063766:Pediatric Obesity / Q000628:therapy*; D016896:Treatment Outcome
Atención primaria; Intervención multicomponente; Multicomponent intervention; Obesidad; Obesity; Overweight; Paediatric; Pediatría; Primary Care; Revisión sistemática; Sobrepeso; Systematic review