Table 1.

Strengths and limitations of psychological intervention designs for treatment of school-aged children with overweight or obesity (Adapted from [21, 58, 71–82] additionally with authors’ opinion)

Methods	Theoretical grounding	Limitations	Strengths
Group-based [21, 58, 71–79]	Psychosocial; cognitive behavioral; social cognitive theory; mindfulness	• Efficacy depends on entire family unit/ group of people • Requires longer timeframes and extensive training of clinical staff • Requires rigid structure/guidelines • Difficult to tease out effectiveness of individual intervention components • Works best in conjunction with other approaches	• May be more effective than cognitive behavioral treatment that does not include family • Appropriate for young and older children • Group-based format facilitates social support and shared social identity (both correlate with health) • Focus often on social environment as well as individual behavior & motivation
Community-based [80, 81]	Psychosocial; cognitive behavioral; motivation theory	• Difficult to implement (requires community involvement, primary care, schools, training of staff, parents, etc.) • May not be as effective in younger populations (pre-treen) • Interventions may take large-group approach (classroom) which may not reach everyone • Requires longer timeframe to implement and evaluate • Requires regular evaluation • Most effective with structural change (e.g., norm-based plus restrictions on junk food in school)	• Prevention and treatment typically in focus • Targeting both norm and structural change • May be more useful in underserved communities • Norm-based interventions have proven efficacious in multiple other health- and non-health-related settings • Effective for children with autonomy as well as parents/care givers/teachers of younger, more dependent children • Focus predominantly on social/structural environment as determinant of individual behavior & motivation • Often holistic approach to health
Individual-based [21, 78, 82]	Psychosocial; cognitive behavioral; dual-process cognition; motivational interviewing	• May be less efficacious in younger and less autonomous populations • Difficult to tease out effectiveness of individual intervention components • Generally mixed evidence for efficacy • Works best in conjunction with other approaches • Lack of focus on social environment, onus is on individual to change • More expensive than group-based interventions	• Dependent only on individual rather than group/family • Tailored to the individual • More intensive and focused than group- or community-based interventions