Preliminary Impact of an Adapted Emotion Regulation Intervention for Overweight and Obese Adolescents Attempting to Lose Weight.

Introduction: National data indicate that approximately 35% of children and adolescents continue to struggle with overweight/obesity. Although considerable attention has been given to comprehensive behavioral interventions to address obesity in children, there is less empirical evidence demonstrating efficacy of interventions with adolescents. Additionally, there is great variability and limited impact of adolescent weight control interventions which may be attributable to the failure of these interventions to explicitly address important individual mechanisms (e.g., emotion regulation abilities) that impact the consistent utilization of learned weight loss strategies. Notably, adolescents with poorer general emotion regulation (ER) have been found to consume more snack/junk food and report greater amounts of sedentary behavior. Poor ER among adolescents has also been associated with more rapid weight gain and greater BMI. In an effort to maximize outcomes, our research team combined two efficacious interventions (one targeting ER with adolescents [TRAC] and the second a standardized behavioral weight management intervention [SBWC]) into a single intervention to improve weight management outcomes among a sample of overweight and obese adolescents. Methods: The developed intervention (HealthTRAC) is comprised of 14, one-hour group based sessions delivered over 16 weeks. It emphasizes recognizing bodily changes that signal emotional arousal, labeling emotions, choosing and implementing strategies to respond to emotions, and using these skills in highly arousing situations including those related to weight management. Data examining BMI were collected at baseline and immediately after intervention completion. Analyses of covariance controlling for baseline BMI were used to evaluate study outcomes. Results: To date, 26 adolescents (M_age=14.6 SD=1.4; 60% female; 50% ethnic or racial minority) have been enrolled and randomized to receive either HEALTH TRAC or SBWC. Of these, 85% (n=22) of participants completed the immediate post-intervention assessment. No differences in the mean number of sessions attended emerged (M_HealthTRAC=9.7 vs M_SBWC=9.3; p=.80) and adolescents in both conditions reported high group satisfaction (M_HealthTRAC =3.4 vs M_SBWC =3.5, on a 4-point scale; p=.75). Adolescents randomized to HealthTRAC demonstrated greater reductions in BMI relative to SBWC (d=1.02, p=.03). Conclusions: This study provides preliminary evidence that the developed HealthTRAC intervention was acceptable, feasible to deliver, and is demonstrating a positive impact on BMI. These data suggest that ER is related to health decision making and will be relevant to the majority of overweight/obese adolescents seeking to lose weight.