Psychological outcomes associated with a residential, activity-based weight loss camp for obese children

Psychosocial problems are the most prevalent form of morbidity associated with childhood obesity. Body shape and weight dissatisfaction, low self-esteem, and victimisation experiences are common in obese children, and intensify with age. Accordingly, any effective treatment must demonstrate psychosocial benefits alongside weight loss. Such benefits are rarely monitored. Moreover, there is concern that intensive weight loss treatments may undermine an already fragile state. This study therefore examined the potential for psychological benefit or jeopardy of a residential, activity-based weight loss camp for obese children and adolescents. Fifty eight obese children (33 girls and 25 boys, mean age 13.9, mean BMI 32.6) completed assessments of self-esteem (Self-Perception Profile for Children, Harter, 1985), salience of weight and shape concerns, and body shape perception at the start and end of the camp. The camp was organised for 6 consecutive weeks, the mean duration of stay being 4 weeks. In addition, data were collected from a comparison group of 39 normal weight children matched for age. MANOVA revealed a significant effect of obesity on self-esteem (F(6,86) = 7.86, p < .001) with univariate tests showing obese children to have lower global self-worth, scholastic competence, athletic competence, physical appearance and behavioural conduct. Significant time by camp interactions showed an increase in obese children's self-worth, athletic competence and physical appearance, but no changes in the comparison group. Obese children worried significantly more than lean peers about their appearance and more generally. The camp did not increase the salience of these worries or the importance attached to physical appearance or athletic competence. There was a decrease in body shape rating consistent with a significant mean weight loss of 5.5 kg. These positive psychological outcomes are notable and consistent with an earlier pilot study. Girls and boys showed similar benefit although by the end of the camp they still had lower self-esteem and more worries than lean peers. Maintenance of these gains is being encouraged and monitored by regular home-based contact. Activity-based programmes show promise for both weight loss and psychological well-being, in contrast to many children's experience of sport in school.