{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:20:00Z","timestamp":1793053200502,"version":"4.5.0"},"reference-count":102,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,7,16]]},"abstract":"<jats:sec id=\"ab-jus240005-1\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Body mass index (BMI) of the 95th or greater percentile for age and sex is common among young people, and its prevalence has increased in recent decades.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jus240005-2\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the benefits and harms of weight management interventions initiated in health care settings among children and adolescents with high BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jus240005-3\">\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>MEDLINE via Ovid, PsycINFO via Ovid, and the Cochrane Central Registry of Controlled Trials through January 12, 2023; ongoing surveillance through January 26, 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jus240005-4\">\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>English-language studies of weight management interventions (behavioral and pharmacologic, including liraglutide, semaglutide, orlistat, and phentermine\/topiramate) among children aged 2 to 18 years with high BMI (eg, \u226585th or \u226595th percentile for age and sex) conducted in or recruited from health care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jus240005-5\">\n                    <jats:title>Data Extraction and Synthesis<\/jats:title>\n                    <jats:p>One investigator abstracted data; a second checked for accuracy. Outcomes with sufficient evidence for meta-analysis were pooled using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jus240005-6\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>BMI and other weight-related outcomes, cardiometabolic measures, quality of life, physical activity, dietary pattern scores, and harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jus240005-7\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-eight randomized clinical trials (RCTs) were included (N\u2009=\u200910\u202f143). Behavioral interventions were associated with small reductions in BMI and other weight outcomes after 6 to 12 months (28 RCTs [n\u2009=\u20094494]; mean difference in change between groups, \u22120.7 [95% CI, \u22121.0 to \u22120.3]). Larger effects were seen in interventions with higher contact hours and that offered physical activity sessions. Reporting was sparse for outcomes other than BMI, with few significant findings. Semaglutide and phentermine\/topiramate had the largest effects on BMI (eg, 1 RCT [n\u2009=\u2009201] for semaglutide; mean difference, \u22126.0 [95% CI, \u22127.3 to \u22124.6]). The very few studies that evaluated outcomes after medication discontinuation showed immediate weight regain. Gastrointestinal adverse effects were common with liraglutide, semaglutide, and orlistat. Serious adverse effects were rare, but no studies had follow-up longer than 17 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-jus240005-8\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In the short term, weight management interventions led to lower BMI in children and adolescents, with no evidence of serious harm. Evidence is lacking about how weight management interventions affect BMI beyond 1 year and after medication discontinuation and about longer-term effects on other outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jama.2024.6739","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T11:17:17Z","timestamp":1718709437000},"page":"233","source":"Crossref","is-referenced-by-count":82,"title":["Interventions for Weight Management in Children and Adolescents"],"prefix":"10.1001","volume":"332","author":[{"given":"Elizabeth A.","family":"O\u2019Connor","sequence":"first","affiliation":[{"name":"Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne V.","family":"Evans","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, 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