**4. Discussion**

This study aimed to describe the growth of research publications regarding interventions for childhood overweight and obesity and to understand the current research landscape by grouping publications according to similarities in the topic areas being researched. By quantifying the scientometrics profile of publications, it is evident that over time, there has been a gradual increase in the publication of research related to interventions and treatments for children with obesity. Applying the LDA technique, we found that the number of publications related to school and community-based intervention has increased over the period. Moreover, the results highlighted the importance of research support in lower-middle-income countries (LMICs), especially, where the prevalence of childhood obesity has been increased [45].

Unsurprisingly, the majority of the research related to interventions and treatment for childhood obesity was conducted in the United States. India and China were the two lower-middle-income countries that appeared the most in the abstracts (Table 2). However, it should be noticed that the majority of children with overweight and obesity live in lower-setting countries, where the rates are rising faster than in high-income countries [48]. The possible causes of this are various, including the Western diet [49], the low activity level [50], or regarding the cultural perspective, where obesity means beauty, better health, power, and higher socioeconomic status [51]. Each LMIC needs to investigate the causes of this phenomenon due to the difference in the contextual background. Yet, due to the limitation in research funding and facilities, human resources, or communication [52], the contextualized evidence might not be found in the short term. Thus, LMICs might benefit from the active research collaboration with developed countries or countries in the same region, such as India and China.

By applying our proposed approach, the combination of scientometrics and content analysis, the present study has identified that there has been a wealth of research conducted globally focusing on the development of the pharmacotherapeutic, family-based, school-based, and community-based interventions, especially in the last five years. Meanwhile, seemingly unidimensional approaches, such as diet or nutrition-related interventions, have reduced. This suggests a definite shift in research towards multifaceted intervention and treatment approaches, particularly those that focus on children's immediate environments. Besides, our studies found that 13.3% of the total papers mentioned pharmacotherapeutic interventions and related chronic conditions. Pharmacotherapy is recommended as a combination method when lifestyle intervention and support from a specialist alone are not enough due to extreme excess weight and related chronic conditions [53]. However, this method should be carefully applied under the supervision of health staff due to some side-effects this may cause to health [54].

The findings suggest some implications for designing interventions, health research, and policy. The number of articles related to the treatment and intervention in poor-resource countries were not high compared with that of high-income countries; meanwhile, the prevalence of obesity and overweight in those settings is increasing. These countries should actively collaborate with other developed countries and countries in the same region (either through their own government or through the support of neighboring/higher-income countries) in order to combat their rising rates of overweight and obesity. Health system strengthening and capacity building, especially in developing countries, will remain as core components of international and national strategies. The developed countries might note the increasing number in the publication regarding the interventions and treatment of childhood obesity. Further research needs to be done to find the most effective strategies of intervention, and treatment of childhood obesity.

Some limitations should be acknowledged. Firstly, the Web of Sciences was the only database used in the analysis. There is a likelihood the low-impact journals, which publish articles from the developing countries, are not being included in the WOS database. Therefore, that may not reflect the development of publications on interventions among children with obesity in developing countries. Future research should consider expanding to other databases to cover the larger number of publications, which contributes more meaningful knowledge to the research field. Secondly, the language of selected papers was restricted to only English. However, there were only 121 papers in other languages, which was a quite small number compared with the total number of papers associated with overweight and obesity in children and youth. Finally, only titles and abstracts were used in the content analysis. However, by quantifying different layers of information (documents by years, citation, and countries where studies conducted) and applying an advanced analytic technique, the Latent Dirichlet Allocation for titles and abstracts analysis [55], we could discover the trend and hidden themes of the research studies [56].
