Recreational Physical Activity Improves Adherence and Dropout in a Non-Intensive Behavioral Intervention for Adolescents With Obesity

ABSTRACT

Purpose: The aim of this study was to compare adherence and dropout rates in adolescents with obesity participating in a behavioral-counseling intervention with or without recreational physical activity (PA). Material and methods: Seventy-four adolescents (13 to 18y, 40 girls and 34 boys) with obesity (body mass index [BMI] z-score ≥ 2.0) were randomized into a counseling group (CG; n = 37) and a counseling + recreational physical activity group (CPAG; n = 37). Adolescents from both groups received behavioral counseling once a week for 12 weeks and monthly for an additional 12 weeks. CPAG adolescents participated in supervised recreational physical activity sessions twice a week for 12 weeks. Body composition, body image dissatisfaction, symptoms of depression, binge eating, bulimia, anorexia and quality of life were assessed at baseline and after 24-weeks. Result: The dropout rate was 2.73 times higher in adolescents from CG compared to CPAG (χ² = 4.48; p = .034; R²_McF = 0.044). Girls were 2.56 times more likely to withdraw when compared to boys (χ² = 3.86; p = .049; R²_McF = 0.038). Binomial logistic regression which incorporated sex, intervention group, BMI z-score and BSQ score at baseline (R²_McF = 0.177) explained 75% of the dropout rate. Both interventions were effective in reducing waist circumference (p < .01) and improving quality of life, symptoms of depression, bulimia and binge eating (p < .01). Conclusion: Incorporating a recreational physical activity component to a non-intensive behavioral intervention may be a feasible strategy to reduce dropout rates in adolescents with obesity seeking treatment.

KEYWORDS:

• Obesity
• adolescents
• treatment dropouts
• physical activity

Acknowledgments

The authors thank to the volunteers and their parents for the participation in this study.

IRB approval

Ethical Committee of the Federal University of São Paulo (#1394/2017)

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This research has been granted by Coordination for the Improvement of Higher Education Personnel (CAPES). Wagner Prado is supported by ASPIRE grants (# UC2 GM137444-02).