Social disparities in obesity treatment for children age 3–10 years: A systematic review

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.