Table 1 Characteristics of included studies

Family based intervention studies

Jiang et al. [67]

<13

Obese children between the grade of 7–9 and their parents of the children.

The focus of the intervention is to evaluate the effectiveness of family based intervention among the school children

- The treatment group showed a statistically significant result in reducing BMI (<0.001) compared to control group

75 families.

participants: n = 68

Condition A- treatment group n = 33 (m/f = 20/13)

Condition B- control group n = 35 (m/f = 21/14)

Garipagaoglu et al. [58]

6-14

Obese children of 6–14 years and/ or their parents, BMI value exceeding the 97th percentile for age and gender is taken as inclusion criteria.

The focus of the study is to assess the short and long term effects of family based group treatment in the management of childhood obesity.

The individual treatment group lost more weight than group treatment.

Self-referred children and their parents.

Statistically significant decrease (BMI, BMI SDS and also in energy intake) is seen among the groups (<0.001)

Unit of allocation into two groups. participants: 80 (51% male and 49% female)

The decrease in the BMI and BMI SDS is not maintained over the follow up measurement period, however there was decline in BMI seen in individual group

Condition A Individual treatment (n = 40)

Condition B group (n = 40)

Kalarchian et al. [51]

8-14

Ninety- three Overweight and Obese children between the ages of 8–14 years and their parents were included in the study.

The focus of the study was to evaluate the efficacy of family based weight control in the management of severe childhood obesity.

The planned contrast showed statistically significant differences in percentage overweight in 6 months and small significant result in other medical parameters by 6–12 months. Children who attended

The participants were recruited through direct mailings, distribution of brochures through local school and community presentations

≥75% of intervention sessions maintained decrease in percentage overweight for 18 months

Total number of participants: 93

a) Condition A- Family Based condition (FB) n = 33

b) Condition B- Parent only (PO) n = 34

c) Condition C- Wait list control condition (WLC) n = 26

Golan et al. [59]

8- 11

Children of 6–11 years and their parents

The focus of the study was to evaluate the relative efficacy of treating obesity via a family- based health centred intervention targeting parent only v. parent and obese children.

At the end of the study, treatment was effective among parent only support. Non obese status was also achieved by two children.

The children were recruited through advertisement in local newspaper.

Condition A (parent only) - 14 families with 17 children

Condition B (Parent and children) – 18 families with 20 children

Golley et al. [68]

6- 9

Total 111(64% female) overweight, prepubertal children between 6- 9 years of age and their parents

The focus of the study is to evaluate the effectiveness of parenting skills training as a key strategy for treatment of overweight children.

-All three groups had a statistically significant reduction over 12 months.

Media publicity and school newsletter.

- In 12 months follow up data shows that BMI z score reduced to 9% in P + DA group, 6% in P group and 5% in WLC group. 45% of children in WLC group increased their BMI z score.

Condition A - Parenting- skills training with intensive lifestyle education (P + DA) n = 38(13)

- All though there is no statistical significance between the groups, BMI has decreased double the number in 12 months.

b) Condition B - Parent alone (P) n = 37(13 boys)

c) Condition C - Wait listed condition (WLC) n = 36(13 boys)

School based intervention studies

Sacher et al. [56]

8- 12

Obese children between the ages of 8–12 years and their parents

The focus of the intervention is to evaluate the effectiveness of the Mind, Exercise, Nutrition, do it (MEND) program, a family based community intervention for childhood obesity.

At six months both waist circumference and BMI were highly significantly less in intervention group than control group when adjusted to baseline.

The participants were recruited from five different UK sites by referral from local health professionals (dieticians, school nurses, and general practitioners) or self-referred.

a) Condition A (Intervention group) - 60 allocated (52%)

b) Condition B (Wait listed group) – 56 allocated (48%)

Goldfield et al. [55]

8- 12

Obese children between 8–12 years and their parents.

To evaluate the effectiveness of family based intervention in terms of cost effectiveness intervention.

The result of the study showed that family based behavioural intervention for childhood obesity is cost effective when provided in group format compared to group plus individualised treatment

Newspaper advertisements and physicians referrals.

Condition A (mixed) - 12

Condition B ( group only) - 12

Carrel et al. [52]

12.5 ± 0.5

School going obese children with an age of 12.5 ± 0.5

To determine the effectiveness of school based fitness program to improve fitness, body composition and insulin sensitivity.

There is greater decrease in percentage of body fat in the treatment group compared with control group after end of 9 months intervention

Recruitment method not mentioned

Condition A: 24 in two groups

Condition B: 24 in two groups 48% were female

Francis et al. [60]

Sixth year primary school

Six year primary school children

The focus of the study is to evaluate the effectiveness of short term, school based, and multi-component education intervention on improving the knowledge, attitude and behaviour of primary school children towards obesity treatment.

The participants in the groups had a BMI ≥85th percentile and they showed changes in BMI.

The district schools were randomly selected by SPSS computer software.

Number of participants in each condition

a) Condition A n = 56

b) Condition B n = 27

Sahota et al. [53]

7-11

Children between the ages of 7–11 years.

The focus of the study is to assess if a school intervention was effective in reducing risk factor and management of obesity

The program was successful in producing changes in school level.

Recruitment method not mentioned

The focus of the intervention is to assess o school based intervention in reducing childhood obesity among urban areas in china.

-Only positive outcome increase in consumption vegetable.

Condition A: n = 314

The study is effective in reducing the childhood obesity among schoolchildren in Beijing.

Condition B: n = 322

Primary school children in grade between 1–4.

Five district schools were selected and randomised into intervention and control group.

Condition A n = 257

Condition B n = 246

Jiang et al. [67]

1-4 primary year school

Primary school children in grade between 1–4.

The focus of the intervention is to assess o school based intervention in reducing childhood obesity among urban areas in china.

The study is effective in reducing the childhood obesity among schoolchildren in Beijing.

Five district schools were selected and randomised into intervention and control group.

Condition A n = 257

Condition B n = 246

Vissers et al. [57]

17 ± 1.3

Secondary school children with the mean age of 17.5 (±1.3 years)

The focus of the study is to evaluate the effect of multidisciplinary school based intervention for the overweight and obese students attending secondary school.

A school based multi-disciplinary lifestyle intervention is effective and had a promising result to reduce body weight, BMI and improve the aspects of the metabolic syndrome.

Secondary vocational education schools were contacted to participate in educational project on nutrition, physical activity and health for all students in third grade.

Condition A (intervention) n = 37

Condition B (control) n = 39