Improving Emotion Regulation Skills Among Adolescents Attempting to Lose Weight

While the prevalence of overweight and obesity among children and adolescents has plateaued,
national data indicate that approximately 35% of children and adolescents continue to
struggle with overweight/obesity. While 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 emotion
regulation abilities that are necessary for weight loss. Notably, adolescents with poorer
general emotion regulation have been found to consume more snack/junk food and report greater
amounts of sedentary behavior. Poor emotion regulation among adolescents has also been
associated with more rapid weight gain and greater BMI. This project adapts a previously
validated Emotion Regulation intervention (TRAC) for at-risk adolescents, targeting sexual
risk reduction, to focus on weight loss among a sample of overweight and obese adolescents
(ages 12 to 18). While sexual risk and weight management are distinct health behaviors, this
same model of emotion regulation could be applied to overweight/obese adolescents attempting
to lose weight. In fact, data from overweight/obese adolescents attending a past outpatient
weight management program (N=124) indicate that 82% of these youth report emotion regulation
scores that are comparable to youth with significant mental health problems. Furthermore,
higher levels of emotional dysregulation was associated with greater BMI within this same
sample. These data suggest that emotion regulation is related to health decision making and
will be relevant to the majority of overweight/obese adolescents seeking to lose weight. The
current study will be carried out across Phase 1a and 1b. During Phase 1a, the initial
acceptability and feasibility of the adapted intervention (HEALTH TRAC) with eight
adolescents in an open pilot trial will be evaluated. During Phase 1b, 48 adolescents between
the ages of 13-17 years will be randomized to receive either the HEALTH TRAC or standard
behavioral weight control intervention (SBWC) and examine the impact on emotion regulation
abilities and BMI status over an eight-month period. The information gained in this project
will improve understanding of strategies to improve weight loss outcomes among
overweight/obsess adolescents and how improving emotion regulation abilities can enhance
these interventions.