Psychosocial Interventions in the Treatment of Severe Adolescent Obesity: The SHINE Program.

PURPOSE: Psychosocial interventions (PSIs) are characterized by three phases: (1) an initial in-depth assessment, (2) an intensive multifaceted intervention to stem a condition, and (3) an extensive maintenance program. PSIs are often used for treatment of mental health conditions; however, applicability in the treatment of adolescent obesity is unknown. This article sought to evaluate the service-level outcomes of a PSI for young people (aged 10-17) with severe obesity. METHODS: A retrospective evaluation of participants attending the Self Help, Independence, Nutrition and Exercise program between 2011 and 2016 (n = 435; age: 13.1 ± 2.1 years, male: 51%, white: 87.4%, body mass index [BMI]: 33.5 ± 7.5 kg/m(2), standardized BMI [BMI SDS]: 3.1 ± .5 units). Anthropometric measurements (BMI and waist circumference) were collected at baseline, 3, 6, 9, and 12 months. Psychosocial measures (anxiety, depression, and self-esteem) were collected at baseline and 3 months. Participant retention was also assessed. RESULTS: After 3 months, 95% of participants remained with a mean BMI SDS reduction of .19 units (95% confidence interval: .17, .21). Anxiety, depression, and self-esteem improved by 50%, 54%, and 38%, respectively. BMI SDS reductions of .29, .35, and .41 units were found at 6, 9, and 12 months. Fifty-four percent of participants chose to attend the final intervention phase. A higher baseline BMI SDS and a greater reduction in BMI SDS predicted final intervention phase attendance. CONCLUSIONS: The Self Help, Independence, Nutrition and Exercise PSI demonstrated positive mean reductions in all measurements across all time points. In contrast to other community-based weight management services, these results suggest the utility of, and further exploration of, PSIs in the treatment of severe adolescent obesity.