Structured Psychoeducation for Unemployed Adolescents With Extreme Obesity in a Multicenter Observational Study Focusing on Feasibility
Condition: Obesity; Extreme Obesity
MeSH terms: Obesity
Study type: Observational

Summary: 
      Obesity occurs more frequently in subjects of a lower socioeconomic status and is associated
      with a lower income and unemployment. On the other hand, there is limited access of
      individuals with low socioeconomic status to conventional obesity treatments and bariatric
      surgery.

      In STEREOplus the investigators will ascertain unemployed adolescents with obesity and
      extreme obesity at five job centers in the Ruhr area. Unemployed obese youths and young
      adults (BMI ≥ 30kg/m2) between the ages of 14 and 24.9 years are eligible to participate.
      Participants will be asked to complete a series of questionnaires on their general health,
      psychosocial situation and wellbeing, and will be offered a thorough medical evaluation.
      Individuals who complete the baseline evaluations will be invited to participate in six group
      sessions of conventional obesity treatment over a three months period. After six months,
      participants will complete further questionnaires to evaluate the effects of the
      interventions on quality of life and psychosocial functioning. Weight status (BMI) will also
      be measured. Adolescents who attended at least five sessions and are interested in bariatric
      surgery will have access to a structured information and preparation program for bariatric
      surgery.

      The overall objective of STEREOplus is to generate data on the feasibility of the planned
      implementation of a treatment targeted to a high risk group with a low socioeconomic
      background in order to reduce treatment barriers.
    

Detailed description: 
      Obesity occurs more frequently in subjects of a lower socio-economic status and is associated
      with a lower income and unemployment. Besides the obesity-related impairments in daily life,
      stigmatisation additionally aggravates the difficulties of vocational integration by multiple
      disadvantages in the process of application for employment, job interviews and performance
      evaluation. On the other hand, there is limited access of individuals with low socioeconomic
      status to conventional obesity treatments and bariatric surgery.

      In this multicenter observational study, the investigators aim to assess the acceptance of a
      manual based low key group intervention targeted at unemployed adolescents (BMI≥30 kg/m2;
      14-24 years old) recruited on the premises of five local job centers in the Ruhr area. The
      study is part of the "Medical and psychosocial implications of adolescent extreme obesity -
      acceptance and effects of structured care", short: "Youth with extreme obesity Study (YES),
      which also comprises the recruitment and characterization of obese (BMI 30-34.9kg/m2) and
      extremely obese (BMI ≥ 35kg/m2) youth from different healthcare- and non healthcare settings,
      a structured prospective evaluation of adolescent bariatric surgery, economic assessments of
      the financial burden of extreme adolescent obesity on the healthcare system, and a long-term
      prospective observation study.

      The participating job centers are located in five cities in the West (Ruhr-Area). The
      investigators will screen 300 unemployed adolescents aged 14 to 24.9 years with obesity and
      extreme obesity (BMI ≥30kg/m2) over a 24 month period. A total of 80 subjects will be
      enrolled. Baseline assessments include an array of standardized questionnaires and validated
      instruments to assess health, psycho-social situation, psychiatric co-morbidities and health
      related quality of life, as well as an in-depth medical evaluation.

      Individuals who complete the baseline evaluations will be invited to participate in six group
      sessions over a three month period. Adolescents who attended at least five sessions and are
      interested in bariatric surgery will have access to a structured information and preparation
      program for bariatric surgery. The adherence and effects of the interventions on BMI, health
      related quality of life and psycho-social functioning will be assessed via questionnaires
      after six months. All statistical analyses will be exploratory/descriptive. The project will
      reveal the feasibility of the implementation of the described intervention approach focusing
      on reducing treatment barriers for unemployed adolescents with obesity.
    

Intervention name(s): Behavioral standardized manual-based multidisciplinary routine care
Intervention type(s): Behavioral
Intervention description(s): Behavioral standardized manual-based multidisciplinary routine care (lifestyle intervention). Six sessions offered over the course of three to six months with a focus on weight loss. The topics 1) causes, consequences and treatment options of obesity, 2) nutrition, 3) eating behaviors and problem solving strategies, 4) self esteem and emotional eating, 5) exercise, and 6) use of media will be covered.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        obese adolescents or young adults presenting at 5 different job centers