Patterns and correlates of adolescent weight change in residential care

Adolescents entering residential care have high rates of clinical weight problems; however, some aspects of the residential setting may be conducive to healthy weight management. This study aimed to examine the change in adolescent weight status from intake to discharge among a large sample of youth in a residential care program (N=1195). Although weight management was not a specific target of the program, adolescents were more likely to move to a healthier weight status than a less healthy one by the end of the placement. Adolescents who were obese at the time of intake (n=274) showed an average decrease of .21 zBMI units, and approximately a quarter of this group moved to a healthier weight category at discharge. These changes compare favorably to outcomes for existing treatments for adolescent weight problems and may represent clinically-meaningful improvements in weight status for many youth. Further, a decrease in psychotropic medication prescriptions was significantly associated with weight loss for adolescents who were overweight at intake. The implications of these findings, including the possible benefits of effective weight management in residential settings and the potential value of highly structured environments in promoting healthy weight among vulnerable adolescents, are discussed.