The Role of Mental Health and Motivation in Outcomes From a Behavioral Health Intervention for Adolescents in Weight Management

Abstract

Obesity is a health concern to pediatric populations globally. Environmental and societal factors like weight stigma and food availability can complicate obesity in pediatric population and can contribute to higher rates of mental health concerns like depression and anxiety. Interdisciplinary weight management interventions utilize behavior change technique, skill building, and healthy lifestyle messaging as effective tools for managing physical and mental health of adolescents. This study examined changes in negative emotionality, motivation, and weight change over an 8-session weight management intervention for adolescents. A variety of statistical methods, including t-tests, regressions, and longitudinal analyses, were used to examine changes in negative emotionality, associations with motivation and any changes in weight through participation in this weight management intervention. Participation in the intervention significantly reduced negative emotionality across the 8 sessions. Additionally, baseline motivation and negative emotionality were significantly associated, indicating a critical link between motivation and symptoms of anxiety and depression in weight management populations. Finally, significant weight changes occurred across the 8 sessions, with .03 kg lost on average per session. Age was the most significant covariate, with older participants at baseline losing more weight per session. These results support the use of multidisciplinary weight management interventions for adolescents. In 8 sessions, for those that completed the program, negative emotionality tied to depression and anxiety symptoms significantly reduced. Further, motivation at baseline was significantly associated with negative emotionality, with lower negative emotionality significantly associated with higher motivation for behavior change. Finally, weight did significantly reduce across the 8 sessions. Though not quite at the safe weight loss standard of .13 kg per week, these results support a weight maintenance framework that may be more sustainable long term. Supplementing group interventions with motivational interviewing sessions may contribute to improvements in health behavior adoption as well as reductions in depression/anxiety symptoms. Further, screening for depression and anxiety, addressing these symptoms in weight management, and providing referrals when necessary is important for weight management efficacy and opportunity for community mental health intervention.