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 overweight and obesity, a relationship that is complex, bidirectional, and often exacerbated by the weight-related side effects of psychotropic medications. This review addressed the research question: How are overweight and obesity addressed in children and adolescents with mental illness? Following JBI and PRISMA-ScR guidelines, a systematic search of PubMed, CINAHL, EMBASE, and PsycINFO was conducted, including studies in English or Scandinavian languages, across all designs, that focused on non-pharmacological approaches for this population aged 0-19 years. The search was completed in May 2025. Nine studies met the inclusion criteria, comprising four qualitative studies, four cohort studies, and one cross-sectional study. Based on inductive content analysis, three overarching 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 repercussions and future directions, highlighting the consequences for children, adolescents, and their families. Overall, interventions mainly target behavior change, with limited attention to structural or systemic factors. These findings underscore the need for tailored guidance and clear clinical strategies to support healthcare professionals and families in addressing weight-related issues in child and adolescent mental health care.