Abstract
BACKGROUND: Childhood overweight or obesity has become one of the world's most concerning health problems. Teleinterventions that deliver health information and behavioral strategies through telephone calls, websites, apps, newsletters, or emails can help manage children's weight-related conditions. OBJECTIVE: This study aimed to systematically evaluate the effects of teleinterventions versus nonteleinterventions on anthropometric outcomes in children with overweight or obesity. METHODS: Randomized controlled trials investigating weight control using teleinterventions in children with overweight or obesity published in the Cochrane Library (including CENTRAL), Embase, PubMed, and Web of Science databases were selected. The outcomes included changes in BMI, BMI z score, body fat, and waist circumference. Two reviewers independently performed evidence selection, data extraction, and risk of bias evaluation. Data were pooled using a random-effects model. Results were presented as the mean difference (MD) with 95% CI. RESULTS: A total of 26 randomized controlled trials involving 2866 children living with overweight or obesity met the eligibility criteria. The pooled results showed that teleinterventions significantly reduced the BMI z score between the fourth and sixth months (MD -0.15, 95% CI -0.23 to -0.08; I2=94%) and between the seventh and twelfth months (MD -0.19, 95% CI -0.34 to -0.03; I2=98%). Similarly, BMI (MD -2.48, 95% CI -4.15 to -0.82; I2=96%) and waist circumference (MD -0.59, 95% CI -1.05 to -0.14; I2=80%) were significantly reduced between the fourth and the sixth months but were nonsignificant between the seventh and twelfth months. Moreover, teleinterventions with family involvement or professional interaction between the fourth and the sixth months provided significant benefits, including reductions in BMI z score (MD -0.16, 95% CI -0.23 to -0.09; I2=96% and MD -0.13, 95% CI -0.20 to -0.05; I2=96%) and BMI (MD -2.50, 95% CI -4.32 to -0.69; I2=96% and MD -2.48, 95% CI -4.15 to -0.82; I2=96%). In addition, teleinterventions with family involvement could significantly reduce waist circumference between the fourth and sixth months (MD -0.75, 95% CI -1.25 to -0.25; I2=52%). Teleinterventions led to a significant reduction in waist circumference in children between the fourth and sixth months (MD -0.88, 95% CI -1.45 to -0.30; I2=75%). However, teleinterventions did not lead to a significant reduction in body fat among children or adolescents with overweight or obesity, even when family members were involved in the intervention. CONCLUSIONS: Teleinterventions, particularly when incorporating family engagement and structured professional interaction, yielded significant short- to medium-term improvements in weight control for children and adolescents living with overweight or obesity compared to nonteleinterventions. These findings highlight the promising role of telemedicine as a valuable modality for addressing the public health challenge of childhood obesity.