Maintaining adherence to behavioral interventions is a major challenge for childhood obesity treatment. The aim of this study was to compare dropout rates between two behavioral intervention programs in adolescents with obesity. One group received behavioral counseling alone while the other group received behavioral counseling with supervised recreational physical activity. Secondary outcomes included changes in body composition, quality of life, depression, and disordered eating behaviors.


Seventy-four adolescents (13 to 18y, 40 girls) with obesity (BMI z-score ≥ 2.0) were randomized into behavior counseling (BC; n=37) and behavior counseling plus supervised recreational physical activity (BC+PA; n=37).Adolescents from both groups received behavioral counseling in small groups (1 hour each) once a week for 12 weeks and monthly for another 12 weeks. C+PA adolescents also participated in supervised recreational physical activity sessions twice a week in small groups (1 hour each) for the first 12 weeks. Body composition, symptoms of depression, disordered eating behavior and quality of life were.


No difference in attendance for intervention sessions between groups (p=0.59). Dropout was higher in BC (37.8%) compared to BC+PA (10.8%) (x2=9.24; p=0.002). No changes were observed for BMI z-score (BC from 3.4+.23 to 3.1+.19; BC+PA from 2.9+.19 to 2.8+.16; p=0.09), body mass (BC from 100.6+4.5 to 100.4+4.9; BC+PA from 93.9+ 3.7 to 93.5+4.1; p=0.73) and body fat (BC from 47.4 + 2.2 to 49.3+2.6; BC+PA from 45.6+1.7 to 45.1+2.1;0.62) between groups. Improvements in quality of life, symptoms of depression, bulimia and binge eating (p<0.001) were seen to a similar extent in both groups, without groups differences.


Both interventions were equally effective in improving health-related and quality of life outcomes among adolescents with obesity. However adding supervised recreational physical activity led to greater adherence to the intervention.