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Narrative Review

Vol. 19 No. 1 (2021)

Childhood Obesity Interventions by Setting

August 26, 2020


Background: To combat the global health crisis of obesity, many interventions have been implemented, including in children and adolescents. This age range is uniquely important because health behavior continues into adulthood, resulting in lifelong health risks or benefits. This narrative review aims to provide a cross section of the scientific literature regarding obesity interventions by setting, including school-based, daycare-based, home-based, healthcare-based, and digital-based, as well as to highlight gaps in research.

Methods: Articles written in English addressing childhood and adolescent obesity interventions were sought online using PubMed and Google Scholar searches. Although some articles were from a global perspective, the majority focused on children in the United States. This search included reviews, individual studies, and other related papers.

Results: School-based interventions are accessible to many, but there is limited evidence of long-term benefits. Home-based interventions were the only setting to have compelling evidence of long-term benefits, although there are several barriers to participation. Healthcare-based interventions are often successful when specific strategies and unique advantages of healthcare settings are utilized. Digital interventions have limited success now, but show potential for cost-effective scaling up as technology improves.

Conclusion:  The clearest gap in research is the lack of long-term studies, especially of school-based and healthcare-based interventions. Thus, it is imperative that investments are made into studies that include follow-up components continuing at least 1-2 years after the intervention. Additionally, home-based interventions have been more successful during early childhood while school-based interventions tend to be more successful during adolescence.


  1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. National Center for Health Statistics Data Brief [Internet]. 2017 October [cited 2020 Aug 25]; 288. Available from:
  2. Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, et al. Obesity in adults: a clinical practice guideline. Can Med Assn J [Internet]. 2020 Aug [cited 2020 Nov 7]; 192(31): E875-891. Available from:
  3. Power K. The COVID-19 pandemic has increased the care burden of women and families. Sust: Sci Prac Pol [Internet]. 2020 Jun [cited 2020 Nov 7]; 16(1): 67-73. Available from Taylor & Francis Online:
  4. Ickes JM, McMullen J, Haider T, Sharma M. Global School-Based Childhood Obesity Interventions: A Review. Int J Environ Res Public Health [Internet]. 2014 Aug [cited 2020 Aug 25]; 11(9): 8940-8961. Available from PMC:
  5. Gill M, Roth SE, Chan-Golsten AM, Rice LN, Crespi CM, Koniak-Griffin D, et al. Evaluation of an Intervention to Increase Physical Activity in Low-Income, Urban Middle Schools. J Sch Health [Internet]. 2019 Jul [cited 2020 Aug 25]; 89(9): 705-714. Available from Wiley:
  6. McKenzie TL, Sallis JF, Prochaska JJ, Conway TL, Marshall SJ, et al. Evaluation of a two-year middle-school physical education intervention: M-SPAN. Med Sci Sports Exerc [Internet]. 2004 Aug [cited 2020 Aug 25]; 36(8): 1382-1388. Available from:
  7. Turner RW, Perrin EM, Coyne-Beasley T, Peterson CJ, Skinner AC. Reported Sports Participation, Race, Sex, Ethnicity, and Obesity in US Adolescents From NHANES Physical Activity (PAQ_D). Glob Pediatr Health [Internet]. 2015 Apr [cited 2020 Aug 25]. Available from PMC:
  8. Neumark-Sztainer DR, Friend SE, Flattum CF, Hannan PJ, Story MT, et al. New moves-preventing weight-related problems adolescent girls a group-randomized study. Am J Prev Med [Internet]. 2010 Nov [cited 2020 Aug 25]; 39(5): 421-432. Available from PMC:
  9. Kelly C, Carpenter D, Behrens TK, Field J, Luna C, et al. Increasing Physical Activity in Schools: Strategies for School Health Practitioners. Health Promot Pract [Internet]. 2019 June [cited 2020 Aug 25]; 20(5): 607-702. Available from PMC:
  10. Sharma M. School-based interventions for childhood and adolescent obesity. Obesity Reviews [Internet]. 2006 Aug [cited 2020 Aug 25]; 7(3): 261-269. Available from PMC:
  11. Bandura A. National Inst of Mental Health. (1986). Prentice-Hall series in social learning theory [Internet]. Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Inc [cited 2020 Aug 25]. Available from:
  12. Shaya FT, Flores D, Gbarayor CM, Wang J. School-based Obesity Interventions: A Literature Review. J School Health [Internet]. 2008 March [cited 2020 Aug 25[; 78(4): 189-196. Available from PMC:
  13. Rathbun A, Zhang A, Snyder TD. Primary Early Care and Education Arrangements and Achievement at Kindergarten Entry. National Center for Education Statistics [Internet]. 2016 Jun [cited 2020 Nov 7]. Available from:
  14. Ammerman AS, Ward DS, Benjamin SE, Ball SC, Sommers JK, et al. An Intervention to Promote Healthy Weight: Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) Theory and Design. Prev Chronic Dis [Internet]. 2007 July [cited 2020 Aug 25]; 4(3). Available from:
  15. Bonis M, Loftin M, Ward D, Tseng TS, Clesi A, et al. Improving Physical Activity in Daycare Interventions. Childhood Obes [Internet]. 2014 Aug [cited 2020 Aug 25]; 10(4). Available from:
  16. Verbestel V, Coen VD, Winckel MV, Huybrechts I, Maes L, et al. Prevention of overweight in children younger than 2 years old: a pilot cluster-randomized controlled trial. Pub Health Nutr [Internet]. 2013 May [cited 2020 Aug 25]; 17(6): 1384-1392. Available from PMC:
  17. Dunton GF, Do B, Want SD. Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the US. BMC Pub Health [Internet]. 2020 Sept [cited 2020 Nov 7]; 20(1): 1351. Available from PMC:
  18. Berge JM, Everts JC. Family-Based Interventions Targeting Childhood Obesity: A Meta-Analysis. Childhood Obes [Internet]. 2015 July [cited 2020 Aug 25]; 7(2). Available from PMC:
  19. Upton P, Taylor C, Erol R, Upton D. Family-based childhood obesity interventions in the UK: a systematic review of published studies. Community Practitioner [Internet]. 2014 July [cited 2020 Aug 25]; 87(5): 25-29. Available from PMC:
  20. Anderson SE, Whitaker RC. Household Routines and Obesity in US Preschool-Aged Children. J Amer Acad Pediatr [Internet]. 2010 March [cited 2020 Aug 25]; 125(3): 420-428. Available from:
  21. Maddison R, Marsh S, Foley L, Epstein LH, Olds T, et al. Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial. Int J of Behav Nutr and Phys Act [Internet]. 2014 Sept [cited 2020 Aug 25]; 11 (111). Available from:
  22. Kothandan SK. School based interventions versus family based interventions in the treatment of childhood obesity- a systematic review. Arc Pub Health [Internet]. 2014 January [cited 2020 Aug 25]; 72(3). Available from PMC:
  23. Brennan L, Walkley J, Wilks R. Parent- and Adolescent-Reported Barriers to Participation in an Adolescent Overweight and Obesity Program. Obes [Internet]. 2012 September [cited 2020 Aug 25]; 20(6); 1319-1324. Available from Wiley:
  24. Seburg EM, Olsen-Bullis BA, Bredeson DM, Hayes MG, Sherwood NE, et al. A Review of Pediatric Care-Based Childhood Obesity Prevention and Treatment Interventions. Curr Obes Rep [Internet]. 2015 June [cited 2020 Aug 25]; 4(2): 157-173. Available from PMC:
  25. Saelens BE, Sallis JF, Wilfley DE, Patrick K, Cella JA, et al. Behavioral weight control for overweight adolescents initiated in primary care. Obes res [Internet]. 2002 January [cited 2020 Aug 25]; 10(1): 22-32. Available from Wiley:
  26. Endevelt R, Elkayam O, Cohen R, Peled R, Tal-Pony L, et al. An Intensive Family Intervention Clinic for Reducing Childhood Obesity. J Amer Board Fam Med [Internet]. 2014 May [cited 2020 Aug 25]; 27(3): 321-328. Available from:
  27. Uesugi KH, Dattilo AM, Black MM, Saavedra JM. Design of a Digital-Based, Multicomponent Nutrition Guidance System for Prevention of Early Childhood Obesity. J Obes [Internet]. 2016 August [cited 2020 Aug 25]. Available from PMC:
  28. Rizzo AS, Lange B, Suma EA, Bolas M. Virtual Reality and Interactive Digital Game Technology: New Tools to Address Obesity and Diabetes. J Diabetes Sci Technol [Internet]. 2011 March [cited 2020 Aug 25]; 5(2): 256-264. Available from PMC:
  29. Smith A. US Smartphone Use in 2015. Pew Research Center [Internet]. 2015 April [cited 2020 Nov 7]. Available from:
  30. Thompson D, Cantu D, Ramirez B, Cullen KW, Baranowski T, et al. Texting to Increase Adolescent Physical Activity: Feasibility Assessment. Am J Health Behav [Internet]. 2017 July [cited 2020 Aug 25]; 40(4): 472-483. Available from PMC:
  31. Kowatsch T, Niben M, Shih I, Ruegger D, Volland D, et al. Text-based Healthcare Chatbots Supporting Patient and Health Professional Teams: Preliminary Results of a Randomized Controlled Trial on Childhood Obesity. Workshop, co-located with the 17th International Conference on Intelligent Virtual Agents (IVA 2017) [Internet]. 2017 August [cited 2020 Aug 25]. Available from:
  32. Jawed N, Mehndi A, Safdar N. Food Choices of Adolescents and Testing the Efficacy of Smart Phone Aided Nutrition Education Program (P21-062-19). Curr Dev Nutr [Internet]. 2019 June [cited 2020 Aug 25]; 3(2). Available from PMC:
  33. Partridge SR, Redfern J. Strategies to Engage Adolescents in Digital Health Interventions for Obesity Prevention and Management. Healthcare [Internet]. 2018 June [cited 2020 Aug 25]; 6(8): 70. Available from PMC:


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