Support After Adolescent Behavioral Weight Loss Treatment During the Transition Into Emerging Adulthood: Qualitative Study.

Background: Obesity is a chronic disease requiring long-term treatment, yet current treatment models do not align with the chronicity of obesity. Current guidelines provide limited direction on how to adapt treatment to support weight loss maintenance as adolescents transition into emerging adulthood, a distinct developmental period from the late teens to the mid-to-late twenties. Objective: This qualitative study aims to (1) better understand adolescents' and their parents' experiences after behavioral weight-loss treatment as they navigate the transition from late adolescence into emerging adulthood and (2) identify the weight-management support needed during this transition. Formative data are critical to understanding the unique needs of youth with obesity after treatment, especially as they navigate the transition from late adolescence to emerging adulthood. Methods: Adolescents and parents (20 dyads; mean adolescent age 16.5, SD 0.6 y) completed semistructured interviews more than 11 months after participation in a 4-month multicomponent behavioral weight-loss treatment. Interview domains included adolescent and parent perceptions of facilitators and barriers to weight management following program completion, as well as needs and preferences for continued support during the transition to emerging adulthood. Adolescents were asked open-ended questions regarding their current health and weight management behaviors, perceived facilitators and barriers to engagement in health behaviors, parental and social support, and preferences for ongoing weight management support. Parents were asked parallel questions addressing their adolescents' behaviors, their evolving roles as their teens transitioned to emerging adulthood, and recommendations for additional support. Interviews were recorded, transcribed verbatim, and thematically analyzed. Results: Adolescents and parents reported that adolescents maintained several weight management behaviors (eg, regular exercise, self-weighing, and improved diet quality), while identifying others as more difficult to sustain (eg, monitoring food intake and meal planning). Reported facilitators included consistent routines and various opportunities for physical activity (eg, diverse exercise options), while barriers included time constraints, competing priorities, and external influences (eg, the eating behaviors of other family members). Both adolescents and parents expressed a desire for continued support during the transition to emerging adulthood to sustain healthy behaviors and navigate changing roles. Most adolescents and parents expressed interest in participating in a booster program to support weight management during this period, particularly to enhance accountability. Preferences for frequency, duration, and format varied (eg, meeting frequency, program length, or in-person vs virtual). Conclusions: Findings identify key weight-management behaviors that families maintained after treatment, as well as areas that require ongoing support. Results underscore the need for continued support for weight-management behaviors during the transition to emerging adulthood and offer guidance on program structure and content. Results can be used to inform the development of a targeted behavioral weight-management transition program that addresses adolescents' evolving needs during the shift to emerging adulthood, improving long-term outcomes and reducing health risks.