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Exploring the evidence base for Tier 3 specialist weight management interventions for children aged 2–18 years in the UK: a rapid systematic review

Brown, Tamara; O’Malley, Claire; Blackshaw, Jamie; Coulton, Vicki; Tedstone, Alison; Summerbell, Carolyn; Ells, Louisa J

Exploring the evidence base for Tier 3 specialist weight management interventions for children aged 2–18 years in the UK: a rapid systematic review Thumbnail


Authors

Tamara Brown

Jamie Blackshaw

Vicki Coulton

Alison Tedstone

Louisa J Ells



Abstract

Background: The impact of specialist weight management services (Tier 3) for children with severe and complex obesity in the UK is unclear. This review aims to examine the impact of child Tier 3 services in the UK, exploring service characteristics and implications for practice. Methods: Rapid systematic review of any study examining specialist weight management interventions in any UK setting including children (2–18 years) with a body mass index >99.6th centile or >98th centile with comorbidity. Results: Twelve studies (five RCTs and seven uncontrolled) were included in a variety of settings. Study quality was moderate or low and mean baseline body mass index z-score ranged from 2.7 to 3.6 units. Study samples were small and children were predominantly older (10–14 years), female and white. Multidisciplinary team composition and eligibility criteria varied; dropout ranged from 5 to 43%. Improvements in zBMI over 1–24 months ranged from −0.13 to −0.41 units. Conclusions: Specialist weight management interventions for children with severe obesity demonstrated a reduction in zBMI, across a variety of UK settings. Studies were heterogeneous in content and thus conclusions on service design cannot be drawn. There is a paucity of evidence for Tier 3 services for children, and further research is required.

Citation

Brown, T., O’Malley, C., Blackshaw, J., Coulton, V., Tedstone, A., Summerbell, C., & Ells, L. J. (2018). Exploring the evidence base for Tier 3 specialist weight management interventions for children aged 2–18 years in the UK: a rapid systematic review. Journal of Public Health, 40(4), 835-847. https://doi.org/10.1093/pubmed/fdx166

Journal Article Type Article
Online Publication Date Dec 8, 2017
Publication Date Dec 31, 2018
Deposit Date Aug 7, 2018
Publicly Available Date Dec 8, 2018
Journal Journal of Public Health
Print ISSN 1741-3842
Electronic ISSN 1741-3850
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 40
Issue 4
Pages 835-847
DOI https://doi.org/10.1093/pubmed/fdx166
Public URL https://durham-repository.worktribe.com/output/1318332

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Copyright Statement
This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of public health following peer review. The version of record Brown, Tamara and O’Malley, Claire and Blackshaw, Jamie and Coulton, Vicki and Tedstone, Alison and Summerbell, Carolyn and Ells, Louisa J (2018) 'Exploring the evidence base for Tier 3 specialist weight management interventions for children aged 2–18 years in the UK : a rapid systematic review.', Journal of public health., 40 (4). pp. 835-847 is available online at: https://doi.org/10.1093/pubmed/fdx166





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