‘Adventure therapy’ combined with cognitive-behavioral treatment for overweight adolescents

Abstract

Objective: Since peers have such an important influence on adolescents, we evaluated the efficacy of adding peer-based 'adventure therapy' to a standard cognitive-behavioral weight control program for overweight adolescents. Methods: Adolescents (N ¼ 76) aged 13-16 years and 20 to 80% overweight (M ¼ 60.56%, s.d. ¼ 15.17%), were randomly assigned to one of two treatment conditions: cognitive-behavioral group treatment with 'adventure therapy' similar to Outward Bound s (cognitive-behavioral treatment with peer-enhanced adventure therapy (CBT þ PEAT)) or cognitive-behavioral group treatment with aerobic exercise (CBT þ EXER). Anthropometric and psychosocial measures were obtained at baseline, at the end of the 16-week intervention, and at 10 months following randomization. Results: Adolescents assigned to both treatment conditions demonstrated significant weight loss over time, F ¼ 29.06, df ¼ 2, 53, Po0.01. Average weight loss did not differ significantly between groups (À5.31 kg for CBT þ PEAT and À3.20 kg for CBT þ EXER) at the end of treatment. There was a significant difference in the percentage of participants maintaining a minimum 4.5 kg (10 pounds) weight loss (35% in the CBT þ PEAT condition vs 12% in the CBT þ EXER condition, P ¼ 0.042) 10 months from randomization. We also observed a significant age by treatment group interaction, such that older adolescents randomized to CBT þ PEAT demonstrated more than four times the weight loss of older adolescents assigned to CBT þ EXER (M ¼ À7.86 kg vs M ¼ À1.72 kg) at the end of treatment. Conclusions: Peer-based 'adventure therapy' is a promising adjunct to standard cognitive-behavioral weight control intervention for adolescents, and may be most effective for older adolescents.

Treating childhood obesity: Family background variables and the child's success in a weight‐control intervention

“…Besides behavioral therapy of eating and physical activity behaviors, dietary, and physical exercise courses, which have been regarded as significant components of weight-loss interventions, 5,6 treatment of obesity in childhood should involve the family environment. [7][8][9] Even though intervention programs have proven effective in reducing weight and have also shown reasonable long-term success, [10][11][12][13][14] far from all attendees respond to therapy. Percentages of those who do not finish interventions mostly average 20% 10,11,13,15 and of those who complete about 37% fail to reduce overweight more than 5%.…”

“…[7][8][9] Even though intervention programs have proven effective in reducing weight and have also shown reasonable long-term success, [10][11][12][13][14] far from all attendees respond to therapy. Percentages of those who do not finish interventions mostly average 20% 10,11,13,15 and of those who complete about 37% fail to reduce overweight more than 5%. 13,14 Particularly in childhood, such negative experiences should be avoided because motivation to control overweight decreases with each failure.…”

retombées du cours collégial "Plein air expérientiel" aux plans personnel et interpersonnel /

“…Nos résultats rejoignent de plusieurs façons ceux d'autres études (Gass, et al, 2003;Haluza Delay, 1999;Harris, et al, 2005;Jelalian, Mehlenbeck, Richardson Lloyd, Birmaher, & Wing, 2006;Stevens, et al, 2004 Au plan méthodologique, certains auteurs suggèrent davantage de rigueur au plan méthodologique. En effet, les études du domaine de l'aventure sont difficilement comparables entre elles, puisque les programmes diffèrent en plusieurs points : ils ne sont pas tous de la même durée, ni de la même structure, tiennent des objectifs différents, etc.…”

Two-Year Follow-up of an Adolescent Behavioral Weight Control Intervention

“…Additional details of the intervention components have been described elsewhere. 10,13 Measures All measures were obtained at baseline, at the end of the 16-week intervention, and at 12 and 24 months following randomization. Participants were offered monetary compensation for time spent completing initial and follow-up evaluations.…”

“…Very few lifestyle interventions have exclusively targeted adolescents, and few of these provide long-term effectiveness results, rarely going beyond 6-or 12-month outcomes. Of note, a recent trial by Savoye and colleagues 6 found that obese children and teenagers (ages [8][9][10][11][12][13][14][15] who were randomized to a 12-month lifestyle intervention were more likely to maintain weight loss at 24-month follow-up than those randomized to a clinic control group; however, this sample was not comprised exclusively of adolescents and was limited by a poor retention rate (43.7%) at 24-month follow-up. A 2-year, family-based behavioral treatment program for overweight adolescents (mean age = 13 years) in China found a BMI reduction of 9.8% among those receiving monthly home visits, as opposed to no cumulative weight change among the control group.…”