Table 1. Characteristics of selected studies.

Author, year, country	Participants, Sample size	Intervention/ Control	Intervention length, Follow-up (FU) from baseline, Retention rate	Intervention provider	Outcomes	Significance difference between groups
RCT, Hospital-based
Kalarchian et. al., 2007, USA	• Age: 8–12 years • Obese (BMI percentile ≥97th), no comorbidities & not on medications to affect weight Parent participation Sample size: 192 (IG: 97; CG: 95)	Family based intervention • 20 weekly 60-minutes group sessions for 6 months • 6 booster sessions (3 group sessions + 3 telephone calls) between 6 & 12 months • Behavioural strategies: goal setting, problem solving & self-regulation skills • PA: education to ↑ PA & ↓ sedentary activities/screen time < 15hours/week • Diet: Traffic light Eating Plan Control: usual care– 2 nutrition consultation to develop individual nutrition plan (Traffic light Eating Plan)	12 months FU: 18 months Retention: At 12 months: IG: 75.3% CG: 69.5% At 18 months: IG: 83.5% CG: 85.3%	Lifestyle coach, dietitian	Primary: 1. Percent overweight (%OW) Secondary: 1. Waist circumference 2. Body fat (DEXA scan) Did not measure PA & dietary intake Measured metabolic health outcomes: BP	Yes, for waist circumference and body fat percentage at 12 months (no measurements done at 18 months) No, for %OW at 12 and 18 months
Golley et. el., 2007, Australia	• Age: 6–9 years • Obese (BMI z-≤3.5), no comorbidities & not on medications to affect weight Parent participation Sample size: 111 (3-arm RCT) (IGP: 37; IGP+DA: 38; CG: 36)	IGP: Intensive lifestyle education • Based on Positive Parenting Program (Triple P) to promote child’s behavior on dietary + activity • 4 weekly 2-hour group sessions • 15–20 minutes of 4 weekly then 3 monthly individual telephone sessions IGP+DA: • Parent: Triple P + 7 intensive lifestyle support group sessions (family focused healthy eating) • Child: structured supervised aerobic activities (details not stated) Control: wait-listed; received general “Healthy Lifestyle” pamphlet + 3–4 5-minutes telephone call (retention strategy)	6 months FU: 12 months Retention: At 12 months: IGP: 78.4% IGP+DA: 81.6% CG: 86.1%	Dietitian, PA experts	Primary: 1. BMI z-scores Secondary: 1. Waist circumference Did not measure PA & dietary intake Measured metabolic health outcomes: BP, glucose, Lipids profile No measurements for CG at 6 months for comparison	No, for BMI z-score & waist circumference at 12 months
RCT, Hospital-based
di Niet et. al., 2012, Netherlands	• Age: 7–12 years • Overweight (BMI SDS >1.1) or obese (BMI SDS >2.3) • no comorbidities Parent participation Sample size: 114 (IG: 73; CG: 68)	Self-monitoring of lifestyle behaviour via a short message service maintenance treatment (SMSMT) using mobile phones with personalized feedback • 8 group sessions in 3 months • Behavioural strategies: coping skills, goal setting, problem solving & self-regulation skills • PA: exercise behavior–content was not stated • Diet: healthy eating–content was not stated Control: Same content as IG but no SMSMT	3 months FU: 12 months Retention: Measured at 12 months only: IG: 86.3% CG: 69.1%	Psychologist, dietitian, paediatrician & physiotherapist	Primary: 1. BMI SDS (z-scores) Secondary: 1. Eating behavior (Dutch Eating behavior questionnaire) Did not measure PA	None for BMI SD scores or eating behavior
Hystad et. al. 2013, Norway	• Age: 7–12 years • Obese (BMI z-scores ≥2) • No comorbidities Parent participation Sample size: 99 (IG: 47; CG: 52)	Therapist-led group (TLG) to enhance parental competence to accomplish targeted lifestyle changes • 10 group sessions + 5 individual sessions on diet and PA • Written manual • Physical activity: at least 1 hour/day of moderate intensity & max. 2 hour/day sedentary behavior • Diet: Healthy eating Control: Self-help group (principle of mutual help, derived from the participants’ own experiences and knowledge. No education or guidance to improve weight	6 months FU: 24 months Retention: At 6 months: IG: 89.3% CG: 90.4% At 24 months: IG: 76.6% CG: 84.6%	Psychologists, dietitians, paediatricians & physiotherapists	Primary: 1. Body fat (DEXA scan) 2. BMI z-scores 3. Dietary intake (4-day food record: Norwegian Food composition table) Did not measure PA	None for body fat, BMI z-score and diet
RCT, Clinic-based
Estabrooks et. al., 2009, USA	• Age: 8–12 years • Overweight or obese (BMI percentile ≥85th) • Did not state about comorbidities Parent participation Sample size: 220 (3-arm RCT) (IGFC: 50; IGGroup: 85; IGIVR:85)	Family connection (FC) Interventions • FC-workbook: self-help connection 61-pages workbook for parents & served as control group • FC group: workbook + 2-hours x 2 weekly group sessions with dietitian • FC interactive voice response (IVR) counselling: workbook+ group sessions +10 automated IVR tailored counselling sessions over 20 weeks • Behavioural strategies: goal setting, problem solving & role modelling • PA: education to ↑ PA & ↓ sedentary activities/TV viewing • Diet: education on healthy eating	6 months FU:12 months Retention: At 6 months IGFC:76% IGGroup:75% IGIVR: 80% At 12 months: IGFC:72% IGGroup:66% IGIVR: 74%	Dietitian (for IGGroup & IGIVR) & research team	Primary: 1. BMI z-score Secondary: 1. Dietary intake (Block Kids Questionnaire) 2. PA (Youth Behavior Risk Survey)	Yes, for BMI z-score Reduced in IGIVR compared to IG FC or IGGroup at 6 & 12 months No, for PA and dietary intake over time
RCT, Research clinic-based
Wafa et. al., 2011, Malaysia	• Age: 7–11 years • Obese (BMI percentile >95th), no comorbidities Parent participation Sample size: 107 (IG: 52; CG: 55)	Adapted program from Scottish Childhood Obesity Treatment Trial • Parent: 8 8-hour group sessions over 26 weeks with dietitian + 1 session with clinical psychologist for behavioural strategies (self-monitoring, goal setting, problem solving & relapse prevention) • PA education (↑ PA & ↓ sedentary activities/TV viewing) • Diet: education on Traffic light eating plans) • Child: PA sessions (details not provided) Control: delayed treatment after 6 months	6 months FU: none Retention: IG: 65% CG: 84%	Dietitian, clinical psychologist. Exercise instructor	Primary: 1. BMI z-score 2. BMI Secondary: 1. PA (accelerometer) Dietary intake not measured	No, for BMI z-score & PA
Boutelle et. al., 2013, USA	• Age: 8–12 years • Overweight or obese (BMI percentile 85th to 98th), no comorbidities Parent participation Sample size: 50 (IG: 25; CG: 25)	Guided self-help pediatric obesity (GSH-PO) • Behavioural program with12 individual sessions over 5 months (alternate week visits for 20 minutes each), • Written manual for child & parent and activities manual & self-monitoring booklets • Behavioural strategies (stimulus control, motivation, cognitive skils, social support & relapse prevention) • PA education (↑ PA & ↓ sedentary activities) • Diet: education on Traffic light eating plans) Control: delayed treatment after 5 months	5 months FU: 11 months Retention: IG: 92% at 5 months; no loss to FU at 11 months CG: 100%	Graduate student in clinical psychology	Primary: 1. BMI 2. BMI z-score 3. % OW Secondary: 1. Dietary intake (3 days 24-hour diet recall) 2. PA (accelerometer)	Yes, for BMI, BMI z-score & %OW at 5 months Yes, for BMI z-score & %OW at 11 months for IG but no control group No for PA and dietary intake over time
RCT, School based
Kalavainen et. al., 2007, Finland	• Age: 7–9 years • Obese (weight for height of 120 to 200%) • No comorbidities Parent participation Sample size: 70 (IG: 35; CG: 35)	Family-centred group program focus on behavioural & solution-oriented therapy • 15 group sessions of 90 minutes • Written manual • Behavioural strategies: cognitive behavioural therapy workbook (Magnificent Kids) • PA: education on ↑ PA & ↓ sedentary activities • Diet: education on healthy diet & meal pattern Control: Routine counseling (booklet on weight management, eating habits & PA + 2 individual sessions with school nurse)	6 months FU: 12 months Retention: IG & CG: 97.1% at 6 months, no loss to FU at 12 months	Dietitian, school nurses	Primary: 1. Weight for height Secondary: 1. BMI 2. BMI SD scores (z-scores) PA or dietary intake were not measured as an outcome	Yes, for weight for height, BMI & BMI-SDS at 6 months Yes, for weight for height & BMI at 12 months
RCT, Home-based
Goldfield et al., 2006, Canada	• Age: 8–12 years • Overweight (BMI percentile 85th to 94th) or obese (BMI percentile >94th) • Watching TV (VCR/DVD or video games) >15 hours • <30 minutes physical activities • No condition that limits PA Parent participation Sample size: 30 (IG: 14; CG: 16)	Open-loop feedback (requires person to do PA, accelerometer measure PA objectively, which provide feedback. Child will be rewarded access to television when perform PA) + reinforcement by a parent • Bi weekly meeting with research team to determine the amount of television time based on the accelerometer • PA accumulated will be rewarded with access to television • Diet: None Control: Open-loop feedback only	8 weeks FU: none Retention: 100% both groups	Not stated	Primary: 1. BMI Secondary: 1. PA (accelerometer) 2. PA (Past Day PA Recall + television viewing time) 3. Dietary intake (3 days 24-hour diet recall)	Yes, for BMI, PA, television viewing time, fat intake, calories from snacks &snack intake during television watching
Maddison et al., 2014, New Zealand	• Age: 9–12 years • Used electronic media (≥15 hours per week,) • Overweight or obese (as per Cole International cut-points) • No condition that limits PA Parent/primary caregiver participation Sample size: 251 (IG: 127; CG:124)	Screen-Time Weight-loss Intervention Targeting Children at Home(SWITCH) • One face-to-face individual education and support for primary caregivers to reduce media use at home. • Monthly e-newsletter on reduced screen-based activity & links to community-based programs • Behavioural strategies: self-monitoring, role modelling • PA: focus on sedentary behavior • Diet: none Control: usual care	24 weeks FU: None Retention: IG: 95% CG: 94%	Primary caregivers	Primary: 1. BMI z-scores Secondary: 1. BMI 2. Waist circumference 3. Body fat (BIA) 4. PA (7-day physical activity questionnaire + sedentary activity) 5. Dietary intake (Food frequency questionnaire)	None for BMI z-scores, BMI, waist circumference, body fat, PA (including sedentary time) and dietary intake
RCT, Community-based
Nemet et al., 2008, Israel	• Age: 8–11 years • Obese (BMI percentile >95th) • No comorbidities • Not on medications that interfere with growth or weight control Parent participation Sample size: 22 (IG: 11; CG:11)	• PA: 2x a week of 1-hour training group session + 1x/week movement therapy group session at Sport Centre + 30–45 minutes home-based walking/weight bearing exercise 2x/week + reduce sedentary behaviour • Diet: 14 sessions with dietitian on food pyramid with written dietary information & received balanced hypocaloric diet Control: 1 x nutritional consultation & instructed to perform physical activity three times per week on their own	3 months FU: None Retention: 100% for both groups	Dietitian, sports trainers, movement therapists	Did not specify which outcomes as primary or secondary outcomes 1. BMI percentile 2. BMI 3. Body fat (BIA) 4. Screen time 5. Diet (2 day 48-hour diet recall)	Yes, for BMI percentiles & screen time
Nemet et al., 2013, Israel	• Age: 7–9 years • Obese • (BMI percentile >98th) • No comorbidities • Not on medication causing obesity Parent participation Sample size: 45 (IG: 25; CG: 20)	• PA: 2x a week of 1-hour training group session + 1x/week movement therapy group session at Sport Centre + 30–45 minutes home-based walking/weight bearing exercise 2x/week + reduce sedentary behavior • Diet: 14 sessions with dietitian on food pyramid with written dietary information & received balanced hypocaloric diet Control: one nutritional consultation and instructed to perform physical activity daily	3 months FU: None Retention: IG: 88% CG: 90%	Dietitian, sports trainers, movement therapists	Did not specify the primary or secondary outcomes 1. Weight 2. BMI percentile 3. BMI 4. Skinfolds (triceps & subscapular) 5. Body fat (BIA) 6. Physical activity pattern (METS) 7. Screen time	Yes, for weight, BMI, BMI percentile, skinfolds & PA
Sacher et al., 2010, UK	• Age: 8–12 years • Obese (BMI percentile ≥ 98th) • No comorbidities Parent participation Sample size: 116 (IG: 60; CG:56)	Mind, Exercise, Nutrition, Do it (MEND) program • Group based sessions for 9 weeks at community venues • 12-weeks of free family swim pass • Behavioural strategies: 8 sessions in 9 weeks on stimulus control, goal setting, reinforcement, response prevention • PA: 18 group exercise sessions for 1 hour, over 9 weeks • Diet: 8 group nutrition education sessions on healthy eating with written instructions Control: Wait-list	6 months FU: 12 months Retention: IG: 61.7% CG: 80.3%	Dietitians, Health trainers	Did not specify the primary or secondary outcomes 1. Weight 2. Waist circumference 3. Lean body mass (BIA) 4. Fat mass (BIA) 5. Body fat (BIA) 6. BMI z-score 7. BMI 8. Physical activity (hour/week) (non-validated questionnaire + sedentary activity) Measured metabolic health outcomes: BP	Yes, for waist circumference, BMI z-score, BMI & sedentary activity at 6 months Yes, for waist circumference, BMI z-scores & PA at 12 months but no comparison control group
Quasi-experimental, Hospital-based
Shalitin et. al. 2009, Israel	• Age: 6–11 years • Obese (BMI percentile >95th) • No comorbidities • Not using medication that might interfere with weight control Sample size: 162 (IGEx = 52, IGDiet = 55, IGDietEx = 55)	IGEx: Exercise intervention (3-day weekly, 90 minutes per training group session) directed by 3 professional coaches IGDiet: Diet education with 12 weekly of 60 minutes group sessions with a dietician with written information on food pyramid and healthy eating. Also prescribed on balanced hypocaloric diet IGDietEx: Combination of both interventions	12 weeks FU: 52 weeks Retention: IGEx: 42.3% IGDiet: 49.1% IGDietEx: 50.9%	Exercise professional coaches, dietitians	Did not specify the primary or secondary outcomes 1. Waist circumference 2. Body fat (BIA) 3. BMI SDS (z scores) 4. BMI PA and dietary intake were not measured as an outcome	Yes, for BMI SDS (GDiet and IGDietEx compared to IGEx at 12 and 52 weeks) None between IGDiet and IGDietEx over time

NOTE: RCT = randomised controlled trial, BMI = body mass index, SDS = Standard deviation scores, IG = intervention group, CG = control group, PA = physical activity, SD = standard deviation, BP = blood pressure, DEXA = Dual-Energy X-Ray Absorptiometry, BIA = Bio-impedance analysis