OBJECTIVE: Since peers have such an important influence on adolescents, we evaluated the efficacy of adding peer-based 'adventure therapy' to a standard cognitive-behavioral weight control program for overweight adolescents. METHODS: Adolescents (N = 76) aged 13 to 16 years and 20 to 80% overweight (mean 60.56%, SD 15.17%), were randomly assigned to one of two treatment conditions: cognitive-behavioral group treatment with 'adventure therapy' similar to Outward Bound (cognitive-behavioral treatment with peer-enhanced adventure therapy (CBT+PEAT)) or cognitive-behavioral group treatment with aerobic exercise (CBT+EXER). Anthropometric and psychosocial measures were obtained at baseline, at the end of the 16-week intervention, and at 10 months following randomization. RESULTS: Adolescents assigned to both treatment conditions demonstrated significant weight loss over time, F = 29.06, df = 2,53, p < 0.01. Average weight loss did not differ significantly between groups (-5.31 kg for CBT+PEAT and -3.20 kg for CBT+EXER) at the end of treatment. There was a significant difference in the percentage of participants maintaining a minimum 4.5 kg (10 pounds) weight loss (35% in the CBT+PEAT condition versus 12% in the CBT+EXER condition, p = 0.042) 10 months from randomization. We also observed a significant age by treatment group interaction, such that older adolescents randomized to CBT+PEAT demonstrated more than four times the weight loss of older adolescents assigned to CBT+EXER (mean -7.86 kg versus -1.72 kg) at the end of treatment. CONCLUSIONS: Peer-based 'adventure therapy' is a promising adjunct to standard cognitive-behavioral weight control intervention for adolescents, and may be most effective for older adolescents.

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