Defense Date


Document Type


Degree Name

Doctor of Philosophy


Counseling Psychology

First Advisor

Marilyn Stern

Second Advisor

Suzanne Mazzeo

Third Advisor

Melanie Bean

Fourth Advisor

Edmund Wickham

Fifth Advisor

Leroy Thacker


Estimated rates of obesity are notably high in the United States and pose a significant public health concern. A number of deleterious physical and psychosocial conditions are associated with pediatric obesity and the cost of its treatment is considerable. Accordingly, the number of weight management treatments has increased to meet this growing public health challenge. Unfortunately, insufficient participation in weight management treatment, namely low adherence and high attrition, often impede the effectiveness of these programs. Although the barriers associated with inadequate adherence and elevated rates of attrition are documented, there is a dearth of research on the predictors of the low participation in pediatric weight management. To address this gap in the literature, the current study examined whether psychosocial (e.g., motivation, mindfulness, depression), biological (e.g., anthropometric, biochemical), and demographic variables predicted adherence and attrition. A series of backward elimination regressions were modeled to identify the biopsychosocial factors that best predicted adherence and attrition in a pediatric weight management program. The study utilized a sample of parent-adolescent dyads (N = 143) from the T.E.E.N.S. program, a multidisciplinary weight management treatment involving behavioral, nutrition, and exercise components for adolescents with obesity. Several demographic characteristics were associated with lower adherence. Parent basic psychological need fulfillment was also significantly associated with six-month attrition. This finding underscores the importance of the parents’ role in the successful completion of a pediatric weight management program. This study contributes to an increased understanding of the factors related to participation in weight management programs, and can inform the refinements of interventions, such as T.E.E.N.S. and related programs.


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