Children and adolescents with obesity experience social discrimination which can contribute to increased depression, reduced self-esteem and poor body image. Physical activity improves these psychological outcomes but its ability to affect such changes in the context of pediatric obesity treatment is unknown. The primary aim of this systematic review was to determine how structured physical activity interventions, in the context of pediatric obesity treatment, affect changes in depression, self-esteem and body image.
A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library and PsychINFO. Eligible studies included a supervised moderate-to-vigorous physical activity intervention conducted at least weekly in free-living children or adolescents (<=18 years) with overweight or obesity, reporting depression, self-esteem and/or body image pre- and post-intervention using validated tools. Meta-analysis, using random effects, was used to combine outcome data and moderator analysis conducted to identify intervention characteristics that may influence outcomes.
Of 3078 articles screened, 29 studies were included in the review. Overall, structured physical activity interventions were associated with reduced depression (SMD [SE] -0.34 [0.06], p < 0.001, I<sup>2</sup> = 77%), increased self-esteem (0.34 [0.04], p < 0.001, I<sup>2</sup> = 78%) and improved body image (0.47 [0.05], p < 0.001, I<sup>2</sup> = 56%). Age, weight-related changes and inclusion of a nutrition or behavioural component did not significantly influence findings, while school settings and longer interventions produced the greatest self-esteem improvements.
Structured physical activity interventions, in the context of pediatric obesity treatment, improve depression, self-esteem and body image. Copyright © 2020 Elsevier Ltd
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