Obesity
Adventure Therapy effective in maintaining weight-loss
By Lifespan
Mar 1, 2006, 17:33

Some overweight teens may have new hope for shedding pounds. A new study suggests that weight-loss programs that encourage peer-support, and focus on building confidence through challenges are effective in helping some adolescents lose weight. This is the finding of a research paper appearing in the January 2005 issue of the International Journal of Obesity by researchers at the Bradley Hasbro Children's Research Center (BHCRC) and The Miriam Hospital.

"Since weight gain in adolescence has been associated with a number of health problems in adulthood, we wanted to find a program that could offer teens an effective weight-loss strategy," says lead author Elissa Jelalian, PhD, a child psychologist with the BHCRC and Brown Medical School.

Seventy-six overweight adolescents (ages 13 to 16) were randomly assigned to one of two treatment plans for 16 weeks: cognitive-behavioral group treatment with Adventure Therapy based on Outward Bound (an educational program that promotes adventure and peer-building activities), or cognitive-behavioral group treatment in conjunction with aerobic exercise.

"We found that the older teens in our sample lost more weight through the Adventure Therapy regimen, and many kept it off at the 10 month follow-up," says Jelalian.

While average weight loss was similar for both groups, the authors saw significant differences between the groups six months after completion of the active intervention. Over twice as many adolescents in the Adventure Therapy group maintained their weight loss. Even more impressive, they found that older adolescents in the adventure therapy group demonstrated more than four times the weight loss of their counterparts in the aerobics group at follow-up.

"This study supports the idea that at ages 15 and 16, adolescents may benefit significantly from peer support. The Adventure Therapy model embraces positive peer encouragement which is why it's so effective," says Jelalian.

Rather than participating in a supervised exercise session together, adolescents assigned to the Adventure Therapy group were asked to work together in cooperative games, trust-building exercises, and problem solving challenges. The final challenge was for adolescents to participate in a ropes course.

Obesity in children and adolescents is a significant public health concern, the authors write. Data from the most recent National Health and Nutrition Examination Survey data (NHANES 1999-2000) indicate that approximately 15 percent of children and adolescents are overweight. The recent Surgeon General's "Call to Action" describes overweight and obesity as a public health epidemic, with specific focus on the impact of overweight for children and adolescents.

"The obesity epidemic our country is facing has created a tremendous need for innovative, effective weight loss strategies for overweight teens," says co-author Elizabeth Lloyd-Richardson, PhD, psychologist at The Miriam Hospital and Brown Medical School. The rise in prevalence of pediatric obesity has been associated with a rise in the diagnosis of non-insulin-dependent diabetes, as well as risk factors for heart disease. Weight increases during adolescence have also been associated with fasting insulin, HDL-cholesterol, and systolic blood pressure in young adulthood.

"Evidence suggests that losing even small amounts of weight (5 to 10 percent of body weight) can have a significant impact on health," says co-author Rena Wing, PhD, director of the Weight Control and Diabetes Research Center at The Miriam Hospital and Brown Medical School.

Furthermore, childhood and adolescent obesity are significant predictors of overweight status in adulthood and pose a risk factor for adult morbidity and mortality, particularly for males, the authors write.

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