World Obesity Federation, London, UK.
The Boden Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
Obes Rev. 2021 Feb;22(2):e13153. doi: 10.1111/obr.13153.
Socio-economic status and ethnic background are recognized as predictors of risk for the development of obesity in childhood. The present review assesses the effectiveness of treatment for children according to their socio-economic and ethnic background. Sixty-four systematic reviews were included, from which there was difficulty reaching general conclusions on the approaches to treatment suitable for different social subgroups. Eighty-one primary studies cited in the systematic reviews met the inclusion criteria, of which five directly addressed differential effectiveness of treatment in relation to social disparities, with inconsistent conclusions. From a weak evidence base, it appears that treatment effectiveness may be affected by family-level factors including attitudes to overweight, understanding of the causes of weight gain and motivation to make and maintain family-level changes in health behaviours. Interventions should be culturally and socially sensitive, avoid stigma, encourage motivation, recognize barriers and reinforce opportunities and be achievable within the family's time and financial resources. However, the evidence base is remarkably limited, given the significance of social and economic disparities as risk factors. Research funding agencies need to ensure that a focus on social disparities in paediatric obesity treatment is a high priority for future research.
社会经济地位和种族背景被认为是儿童肥胖发展风险的预测因素。本综述评估了根据社会经济和种族背景对儿童进行治疗的效果。纳入了 64 项系统评价，其中很难就适合不同社会亚组的治疗方法得出一般性结论。在系统评价中引用的 81 项原始研究符合纳入标准，其中 5 项直接涉及与社会差异相关的治疗效果的差异，结论不一致。从证据基础较弱的情况来看，治疗效果似乎可能受到家庭层面因素的影响，包括对超重的态度、对体重增加原因的理解以及改变健康行为的意愿和动机。干预措施应该具有文化和社会敏感性，避免污名化，鼓励动机，认识到障碍，并加强机会，并在家庭的时间和财力资源内实现。然而，鉴于社会和经济差异作为风险因素的重要性，证据基础非常有限。研究资助机构需要确保关注儿科肥胖治疗中的社会差异是未来研究的重中之重。
