Child and Adolescent Health Programs in Obesity and Depression: A Systematic Review and Meta-Analysis

Abstract

Obesity and depression are public health issues of increasing concern worldwide. This study aims to evaluate programs that address obesity and their impact on depressive symptoms in children and adolescents. Obesity and depression share a bidirectional relationship, where each can serve as both a cause and a consequence of the other. Methods: A systematic review and meta-analysis were conducted following PRISMA criteria, with the registration recorded under PROSPERO code (CRD42024550644). The selected publications report on intervention programs for obesity and depression in children and adolescents aged 6 to 18 years. The selection was from databases including PUBMED, SCOPUS, LILACS, COCHRANE, WOS, SciELO, and ScienceDirect, using PICOS criteria to define inclusion. ROB-2 and ROBINS-1 were applied to assess bias. Results: Out of 3376 articles reviewed, eight met the inclusion criteria, some including several programs. These programs varied in duration and type, demonstrating changes in reducing Body Mass Index (BMI) and depressive symptoms. However, evidence supporting the effectiveness of programs that address both conditions is limited, particularly in developing countries. Additionally, the results exhibit high heterogeneity due to the diversity of evaluation criteria and methodological approaches, highlighting considerable risks of bias. Conclusions: Intervention programs for obesity management show statistically significant effects on depressive symptoms, although there is heterogeneity in the designs for their standardization and long-term follow-up strategies; however, the evaluations consider DSM-5 and ICD-11 criteria, which contributes to homogeneity. It is vital to address these closely related issues from a multidimensional perspective, considering socio-emotional and psychological factors, and to promote early intervention to maximize effectiveness and enhance quality of life at various stages of development.