title: '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 = 76) aged 13-16 years and 20 to 80% overweight (M = 60.56%, s.d.=15.17%), were randomly assigned to one of two treatment conditions: cognitive-behavioral group treatment with 'adventure therapy' similar to Outward Bound (cognitive-behavioral treatment with peer-enhanced adventure therapy (CBT + PEAT)) or cognitive-behavioral group treatment with aerobic exercise (CBT+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 = 29.06, df = 2, 53, P < 0.01. Average weight loss did not differ significantly between groups (-5.31 kg for CBT + PEAT and -3.20 kg for CBT + 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 + PEAT condition vs 12% in the CBT+EXER condition, P = 0.042) 10 months from randomization. We also observed a significant age by treatment group interaction, such that older adolescents randomized to CBT + PEAT demonstrated more than four times the weight loss of older adolescents assigned to CBT + EXER (M = -7.86 kg vs M = -1.72 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.
authors.affiliation: Department of Psychiatry, Rhode Island Hospital, Brown Medical School, Providence, 02903, USA. Elissa_Jelalian@brown.edu
authors.forename: E
authors.initials: E
authors.lastname: Jelalian
authors.forename: R
authors.initials: R
authors.lastname: Mehlenbeck
authors.forename: E E
authors.initials: EE
authors.lastname: Lloyd-Richardson
authors.forename: V
authors.initials: V
authors.lastname: Birmaher
authors.forename: R R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000886:Anthropometry; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D050177:Overweight; D010349:Patient Compliance; D017060:Patient Satisfaction; D010379:Peer Group; D011615:Psychotherapy, Group / Q000379:methods*; D012649:Self Concept; D015431:Weight Loss