Non-Pharmacological Approaches to Addressing Overweight and Obesity in Children and Adolescents with Mental Illness: A Scoping Review of Quantitative and Qualitative Evidence

Children and adolescents with mental illness are at increased risk of developing over-weight and obesity, a relationship that is complex, bidirectional, and often exacerbated by the weight-related side effects of psychotropic medications. This review addressed the re-search question: How are overweight and obesity addressed in children and adolescents with mental illness? A systematic search of PubMed, CINAHL, EMBASE, and PsycINFO was conducted, including studies in English or Scandinavian languages across all de-signs that focused on non-pharmacological approaches for this population aged 0-19 years. Nine studies met the inclusion criteria, comprising four qualitative studies, four cohort studies, and one cross-sectional study. Based on content analysis, three overarch-ing themes were developed; Approaches to weight and health, showing a predominant focus on individual lifestyle modifications; Roles, resources, and prioritization, reflecting how constrained resources influence healthcare professionals' decisions, and Critical re-percussions and future directions, highlighting the consequences for children, adoles-cents, and their families. Overall, interventions mainly target behavior change, with lim-ited attention to structural or systemic factors. The findings underscore the need for tai-lored guidance and clear clinical strategies to support healthcare professionals and fami-lies in addressing weight-related issues in child and adolescent mental health care.