1 Sydney Medical School, The University of Sydney, Westmead, Australia.
2 Charles Perkins Centre, The University of Sydney, Camperdown, Australia.
3 Department of Psychology, Concordia University, Montreal, Canada.
4 Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada.
5 Research Institute of the McGill University Health Research Centre (RI-MUHC), Montreal, Canada.
6 Department of Pediatrics, McGill University, Montreal, Canada.
7 Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia.
8 Department of Psychiatry, McGill University, Montreal, Canada.
9 Eating Disorders Continuum & Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada.
10 Department of Medicine (Division of Gastroenterology), McGill University, Montreal, Canada.
11 Kids Research, The Children's Hospital at Westmead, Westmead, Australia.

Background: Pediatric obesity is associated with co-occurring psychosocial conditions, which may be impacted by obesity treatment. Past systematic reviews have shown positive effects for specific psychosocial outcomes following behavioral interventions. This review aimed to extend these findings by mapping patterns of change for the totality of psychosocial outcomes reported.

Methods: We conducted a scoping review following published guidelines. We searched 11 databases to identify behavioral intervention trials for children and adolescents living with overweight or obesity that measured at least one psychosocial outcome pre-post. Outcomes were grouped into categories thematically, and data were synthesized based on the timepoint (post-intervention, latest follow-up), intervention arm (active, no-intervention control), and type of change reported (difference between arms, change over time).

Results: Of 1172 articles screened, 197 articles (169 trials) met the inclusion criteria, with a combined sample of 18,694 children and adolescents. A total of 372 outcomes were identified and grouped into eight constructs. Across all outcomes and timepoints, many trials reported no difference or a difference favoring the active intervention arm over the no-intervention control arm. Likewise, most active intervention arms showed improvements or no change over time, though five of 169 trials reported worsening in a psychosocial outcome at post-intervention. Most no-intervention control arms showed no change over time.

Conclusions: Behavioral interventions are associated with improvements or no change in psychosocial health across a broad range of outcomes assessed. Consensus on core psychosocial outcomes is needed to reduce heterogeneity and ensure outcomes are relevant to children and adolescents living with obesity.