The Effects of Teleinterventions on Pediatric Weight Control: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Childhood overweight or obesity has become one of the world’s most concerning health problems. Tele-interventions that deliver health information and behavioral strategies through telephone, websites, apps, newsletters, or email to managing children’s weight-related conditions. Objective: To systematically evaluate tele-intervention versus non-tele-intervention effects on anthropometric outcomes in children with overweight or obesity. Methods: Randomized controlled trials (RCTs) of weight control using tele-interventions in children with overweight or obesity published in Cochrane Library (including CENTRAL), Embase, PubMed, and Web of Science were selected. The outcomes included changes of body mass index (BMI), BMI z-score, body fat, and waist circumference. Two reviewers independently worked for evidence selection, data extraction, and risk of bias evaluation. Data were pooled using random-effects model. Results were presented in mean difference (MD) with 95% confidence interval (CI). Results: A total of 26 RCTs involving 2,866 children living with overweight or obesity met eligibility criteria. The pooled results showed that tele-interventions significantly reduced BMI z-score between the fourth and the sixth months (MD = -0.15; 95% CI: -0.23 to -0.08; I2 = 94%) and between the seventh and twelfth months (MD = -0.19; 95% CI: -0.34 to -0.03; I2 = 98%). Similarly, BMI (MD = -2.48; 95% CI: -4.15 to -0.82; I2 = 96%) and waist circumference (MD = -0.59; 95% CI: -1.05 to -0.14; I2 = 80%) was significantly reduced between the fourth and the sixth months, but was non-significant between the seventh and twelfth months. Moreover, tele-intervention with family involvement or professional interaction between the fourth and the sixth months provided significant benefits, including reductions in BMI z-score (MD = -0.16; 95% CI: -0.23 to -0.09; I2 = 96% and MD = -0.13; 95% CI: -0.20 to -0.05; I2 = 96%) and BMI (MD = -2.50; 95% CI: -4.32 to -0.69; I2 = 96% and MD = -2.48; 95% CI: -4.15 to -0.82; I2 = 96%), respectively. Besides, tele-intervention with family involvement could significantly reduce waist circumference between the fourth and sixth months (MD = -0.75; 95% CI: -1.25 to -0.25; I2 = 52%). Tele-intervention had significant reduction in waist circumference in children between the fourth and sixth months (MD = -0.88; 95% CI: -1.45 to -0.30; I2 = 75%). However, tele-interventions did not lead to a significant reduction in body fat among children or adolescents with overweight or obesity, even when family members were involved in the intervention. Conclusions: Tele-interventions, particularly when incorporating family engagement and structured professional interaction, yielded significant short- to medium-term improvements in weight control for children and adolescents with overweight or obesity compared to non-tele-interventions. These findings highlight the promising role of telemedicine as a valuable modality to address the public health challenge of childhood obesity. Clinical Trial: PROSPERO CRD42022328874; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022328874.