Researchers looked at 33 studies involving nearly 6,000 teenagers with obesity to see if programs combining diet, exercise, and behavior changes actually work long-term. They found that these programs might help a little bit with weight and quality of life after one year, but the benefits are small. Programs run in communities (like schools) seemed to work slightly better than those in hospitals or clinics. However, most programs didn’t show big improvements in mental health, physical activity levels, or lasting weight loss after two years.

The Quick Take

  • What they studied: Whether programs that combine healthy eating, exercise, and behavior coaching help teenagers with obesity lose weight and feel better long-term
  • Who participated: Nearly 6,000 teenagers aged 10-19 with obesity from 33 different studies, mostly from wealthy countries
  • Key finding: These programs may help a little with weight and quality of life after one year, but the improvements are small and may not last
  • What it means for you: If you’re a teen struggling with weight, these programs might help somewhat, but don’t expect dramatic changes - focus on building healthy habits for life

The Research Details

This was a meta-analysis, which means researchers gathered data from 33 separate studies and combined the results to get a bigger picture. All the original studies were randomized controlled trials - the gold standard for research - where some teens got the weight loss programs and others didn’t, so researchers could compare what happened. The programs had to include at least two components: changes to diet, physical activity, or behavior coaching. Researchers only included studies that followed teens for at least one year to see if benefits lasted.

By combining results from many studies, researchers can be more confident about what works and what doesn’t. Looking at long-term results (one year or more) is crucial because many weight loss programs show short-term benefits that disappear over time.

This review was published in the Cochrane Database, which is considered the most trusted source for medical research reviews. However, the certainty of evidence was mostly ’low’ to ‘very low,’ meaning we can’t be completely sure about the results due to differences between studies and other limitations.

What the Results Show

Programs run in healthcare settings (hospitals, clinics) showed little to no improvement in physical well-being, mental health, or physical activity levels after one year. They did show a small improvement in quality of life and a tiny reduction in BMI z-score (a measure of weight adjusted for age and height). Community-based programs (in schools, churches, community centers) performed slightly better, showing small improvements in physical well-being and possibly reducing BMI z-score after two years, though the evidence is limited.

Most studies focused on family-based approaches, involving parents and teens together rather than working with teens alone. Very few studies reported any harmful effects from the programs, but this might be because researchers didn’t look for them carefully. The programs typically included group or individual sessions covering healthy eating, exercise, and behavior change strategies.

These findings align with previous research showing that while weight loss programs for teens can help in the short term, maintaining long-term benefits is challenging. The small effect sizes found in this review confirm that current approaches have limited effectiveness for lasting change.

Most studies were done in wealthy countries with limited diversity, so results may not apply to all populations. The quality of evidence was low for most outcomes, meaning we can’t be very confident in the results. Studies used different ways to measure success, making it hard to compare results. Many studies had high dropout rates, and researchers couldn’t always tell if the programs were implemented as planned.

The Bottom Line

Based on this research, multimodal programs may provide small benefits for teens with obesity, but expectations should be realistic. Community-based programs might be slightly more effective than healthcare-based ones. Focus should be on building sustainable healthy habits rather than expecting dramatic weight loss.

Teenagers with obesity and their families should know that while these programs might help, the benefits are typically small. Healthcare providers should set realistic expectations and consider community-based approaches when possible. More research is needed for teens from diverse backgrounds and lower-income families.

Small improvements in quality of life and weight might be seen after one year, but don’t expect major changes. Long-term success likely depends more on maintaining healthy habits than on the specific program used.

Want to Apply This Research?

  • Track daily healthy behaviors (like eating vegetables, being active for 30 minutes, getting enough sleep) rather than focusing only on weight changes
  • Set small, achievable goals for healthy eating and physical activity that can be maintained long-term, and involve family members in the process
  • Monitor quality of life measures (energy levels, mood, sleep quality) alongside weight-related metrics, as these may improve even when weight changes are small

This information is for educational purposes only and should not replace professional medical advice. Teens with obesity should work with healthcare providers to develop safe, appropriate weight management plans. Individual results may vary significantly from those reported in research studies.