INTRODUCTION: Behavioural interventions are foundational for obesity care, however there are ongoing concerns interventions may influence eating disorder risk. This study aimed to describe the intervention components of adolescent behavioural weight management trials eligible for the Eating Disorders In weight-related Therapies (EDIT) Collaboration.
METHODS: Eligible studies were randomised controlled trials of behavioural weight management conducted in adolescents with overweight or obesity that measure eating disorder risk pre- and post-intervention. Systematic searches were conducted in four databases and two clinical trial registries. Delivery features (i.e. how an intervention was delivered) and intervention strategies (i.e. behaviour change components) were coded from published intervention descriptions using a project-specific codebook, with coding validated with trial investigators. Outcomes were summarised in a narrative synthesis.
RESULTS: Of the 11,860 records screened,41 trials were eligible. Twenty-three studies, consisting of 54 intervention arms, conducted between 1989 and 2020, were validated and included in analysis. Interventions most frequently focused on weight loss and maintenance (54%) and included cognitive behavioural therapy (43%) underpinning the intervention. Interventions targeted an individual with a support person (69%). The median intervention duration was 26 weeks, using either weekly (35%) or staged (e.g. weekly, then monthly) visits (41%). The most frequent intervention strategies included education on healthy eating (89%), education on increasing physical activity (89%) and problem-solving barriers to dietary change (80%). Few trials included mental health related strategies, with only 17% of trials addressing mental health conditions and 11% of trials providing strategies to monitor ‘psychosocial health’. Two-thirds of interventions included ‘dietary prescription’ (65%), and 78% promoted ‘healthful/helpful eating behaviours’.
CONCLUSION: Adolescent weight management interventions are complex and vary in delivery features and intervention strategies. Understanding interventions is a critical first step to designing weight management interventions to reduce eating disorder risk.