Abstract
Childhood overweight and obesity remain major global public health challenges associated with increased cardiometabolic risk, psychosocial complications, and persistence into adulthood. Lifestyle interventions are considered the first-line strategy for obesity prevention and treatment in pediatric populations. The aim of this systematic review was to evaluate the effectiveness of lifestyle interventions in preventing and treating overweight and obesity among children and adolescents aged 0–18 years. A systematic literature review of randomized controlled trials published between January 2016 and March 2026 was conducted using PubMed and Google Scholar databases. Studies involving dietary, physical activity, behavioral, family-based, school-based, or technology-assisted interventions were included. Following screening and eligibility assessment, 39 randomized controlled trials were included in the narrative synthesis. Most interventions combined nutritional education, physical activity, behavioral strategies, and family or school involvement. Family-based and intensive multicomponent interventions demonstrated the most consistent improvements in body mass index (BMI) and health-related behaviors. School-based interventions generally improved lifestyle behaviors; however, their effects on anthropometric outcomes were less consistent. Technology-assisted interventions, including exergaming and wearable devices, produced mixed results. Several studies also reported improvements in metabolic parameters, physical activity, and quality of life despite modest BMI reductions. Overall, lifestyle interventions may support the prevention and treatment of childhood obesity, although their effects on BMI are generally moderate. The most effective interventions appear to be intensive, family-centered, and multicomponent. Future research should focus on long-term follow-up, implementation feasibility, and sustainable intervention strategies.