Background

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.

Methods

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.

Results

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, I² = 77%), increased self-esteem (0.34 [0.04], p < 0.001, I² = 78%) and improved body image (0.47 [0.05], p < 0.001, I² = 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.

Conclusions

Structured physical activity interventions, in the context of pediatric obesity treatment, improve depression, self-esteem and body image.

中文翻译：

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基于体育活动的小儿肥胖症治疗，抑郁，自尊和身体形象的研究：荟萃分析的系统评价

背景

肥胖的儿童和青少年会遭受社会歧视，这会加剧抑郁症，自尊心下降和身体形象差。进行体育锻炼可以改善这些心理结果，但在小儿肥胖症治疗中影响这种变化的能力尚不清楚。这项系统评价的主要目的是确定在儿童肥胖治疗的背景下进行的结构性体育活动干预如何影响抑郁症，自尊和身体形象的变化。

方法

使用MEDLINE，EMBASE，Cochrane图书馆和PsychINFO电子数据库对截至2019年6月的已出版文献进行了系统的检索。符合条件的研究包括至少每周对体重过重或肥胖的自由生活儿童或青少年（≤18岁）进行有监督的中度至剧烈的体育锻炼干预，报告其抑郁症，自尊和/或运动后的身体形象使用经过验证的工具进行干预。使用随机效应的荟萃分析将结局数据与主持人分析结合起来，以识别可能影响结局的干预特征。

结果

在筛选的3078篇文章中，有29篇研究被纳入评论。总体而言，有组织的体育锻炼干预措施与抑郁症减轻（SMD [SE] -0.34 [0.06]，p <0.001，I ²  = 77％），自尊增加（0.34 [0.04]，p <0.001，I ²  = 78％）和改善的身体形象（0.47 [0.05]，p <0.001，I ²  = 56％）。年龄，与体重相关的变化以及营养或行为成分的摄入并没有显着影响研究结果，而学校环境和更长的干预措施可以最大程度地提高自尊心。

结论

在小儿肥胖症治疗的背景下，有组织的体育锻炼干预措施可改善抑郁症，自尊和身体形象。