Self-esteem outcomes over a summer camp for obese youth

Background and Objectives: Variation in the existing literature on the psychosocial benefits of weight loss in obese youth results, in part, from methodological limitations and modest weight loss. Accordingly, this research assessed perceived self-competence and low self-esteem during an intensive weight loss program in a large sample of obese youth, and related these to starting weight, gender, and weight loss. Methods: Over four years, 303 obese male and female adolescents (BMI 34.3 kg/m2, BMI sds 2.99; 14.7 yrs.) attended a residential weight loss camp for a mean duration of 31 days. Outcome variables included dimensional self-esteem (Harter) and weight change over the camp. Results: At the start of camp, obese youth scored highest on social acceptance and lowest on physical appearance and athletic competence. Global self-worth and most domains of self-competence improved significantly over the intervention. The proportion with low global self-worth reduced from 35% to 16% but there was little change in the proportion reporting high self-competence (23%). Mean weight loss was -5.5kg (BMI sds -0.25), with boys and those heaviest at the start losing most. Weight loss was significantly correlated with improved physical appearance (r=0.13) and athletic competence (r=0.19) but not global self-worth. Conclusions: This intensive weight loss intervention yielded significant psychological benefit, especially in self-competence and among individuals achieving most weight loss. The weak association with weight loss suggests the influence of other contributing environmental or social features that should be the focus of further research.