| Summary: | Childhood obesity is one of the most serious public health challenges of the 21st century, with consequences lasting into adulthood. Internet of Things (IoT)-enabled devices have been studied and deployed for monitoring and tracking diet and physical activity of children and adolescents as well as a means of providing remote, ongoing support to children and their families. This review aimed to identify and understand current advances in the feasibility, system designs, and effectiveness of IoT-enabled devices to support weight management in children. We searched Medline, PubMed, Web of Science, Scopus, ProQuest Central and the IEEE Xplore Digital Library for studies published after 2010 using a combination of keywords and subject headings related to health activity tracking, weight management, youth and Internet of Things. The screening process and risk of bias assessment were conducted in accordance with a previously published protocol. Quantitative analysis was conducted for IoT-architecture related findings and qualitative analysis was conducted for effectiveness-related measures. Twenty-three full studies are included in this systematic review. The most used devices were smartphone/mobile apps (78.3%) and physical activity data (65.2%) from accelerometers (56.5%) were the most commonly tracked data. Only one study embarked on machine learning and deep learning methods in the service layer. Adherence to IoT-based approaches was low but game-based IoT solutions have shown better effectiveness and could play a pivotal role in childhood obesity interventions. Researcher-reported effectiveness measures vary greatly amongst studies, highlighting the importance for improved development and use of standardised digital health evaluation frameworks. Author summary Obesity is a serious public health concern affecting a growing number of children worldwide and can have long lasting effects on their physical and mental well-being. Health and fitness apps have become an increasingly common means for people to manage their weight and new technologies that can connect to the Internet–such as wearable sensors–are becoming increasingly available. We have conducted a systematic review of studies that described internet-enabled interventions for childhood obesity. In our results and discussion, we provide details of the types of devices, the way they collect, transfer, and analyse data, their aims, and their reported impact. In addition to summarizing the current state of these internet-enabled weight management devices, we discuss areas for future research to improve and better evaluate these devices.
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