Adding emotion management skills to family weight treatment may help teens maintain weight loss

by University of California - San Diego

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Researchers from the University of California San Diego have found that adding emotion management skills to family-based behavioral weight management may help adolescents maintain weight loss after treatment ends.

In a randomized clinical trial of 166 adolescents and their parents, one group received a family-based program focused on healthy eating, physical activity and behavior change, while the other received the same program with additional strategies for understanding and managing emotions.

Teens in both groups lost weight during the six-month program, but those who also learned how to manage their emotions regained significantly less weight during the following year.

The study was published Oct. 22, 2026, in JAMA Network Open.

Adolescence adds emotional challenges

Family-based behavioral treatment is an established approach to helping young people manage their weight. This program typically combines nutrition and physical activity education with strategies such as self-monitoring, goal-setting, problem-solving and positive reinforcement, while teaching parents ways to support their adolescent's behavior changes.

However, previous research has suggested that family-based treatment may become less effective as children enter adolescence. Adolescents are becoming more independent, while their emotional and social lives are also changing.

Emotion management—the ability to understand, manage and respond to emotions—develops during adolescence and can influence eating and physical activity behaviors. Standard family-based treatment does not specifically teach emotion management strategies.

"Adolescence is a time when young people are gaining independence and learning how to manage increasingly complex emotions, so treatment needs to evolve with them," said Kerri Boutelle, professor of pediatrics and psychiatry at UC San Diego School of Medicine and professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science.

"Considering that 43% of adolescents in the U.S. have overweight or obesity, supporting adolescents in managing their emotions and eating could make weight management last."

Testing emotion-focused treatment

For the new study, researchers compared standard family-based behavioral treatment with an enhanced version that incorporated skills from two forms of therapy: dialectical behavior therapy, which includes strategies for managing emotions and distress, and emotion-focused therapy, which emphasizes awareness, acceptance and validation of emotions.

Both groups included adolescents ages 13 to 16 and one parent. Families participated in six months of treatment that included group sessions and behavioral coaching. The study enrolled 166 parent-adolescent pairs at UC San Diego and the University of Minnesota. Participants were assessed at the beginning of the study, during treatment, immediately after treatment and six and 12 months later.

The researchers found that adolescents in both groups had similar weight loss during treatment. However, 12 months after treatment ended, the adolescents who received the emotion-focused treatment had regained less weight than those who received standard family-based treatment.

The difference was also reflected in the number of adolescents who achieved what the researchers defined as a clinically meaningful amount of weight loss. At the end of treatment, 26% of adolescents in the emotion-focused group and 22% in the standard treatment group had achieved that level of weight loss. Twelve months after treatment ended, these proportions were 22% and 4%, respectively.

Less emotional eating, unclear mechanisms

The enhanced treatment also appeared to affect emotional eating. While the two groups did not differ in emotional eating midway through treatment, adolescents receiving the emotion-focused intervention reported less emotional eating immediately after treatment and at both follow-up assessments. By the 12-month follow-up, the difference between the groups was statistically significant.

The researchers did not find a difference between the groups in overall emotion regulation skills as measured by their primary questionnaire. Boutelle and her colleagues suggest that the intervention did not change broad emotion management abilities, but instead helped weaken the connection between difficult emotions and eating.

"The fact that we saw less emotional eating and better weight maintenance, without a measurable change in overall emotion management, raises an important question about what is actually driving the benefit," Boutelle said. "We need to understand which parts of the intervention are most important and whether helping adolescents respond differently to difficult emotions is the key."

The researchers note that future studies could examine whether changes in adolescents' coping skills, parents' responses to their children's emotions or the interaction between the two are responsible for the improved weight maintenance. They also found that the enhanced treatment appeared to be more effective for boys than girls during follow-up, although the reason for this difference is unclear and requires further study.

Making weight management more durable

The researchers emphasize that the findings do not show that emotion management training produces greater initial weight loss. Rather, they suggest that addressing emotional factors may make behavioral treatment more durable—an important consideration because maintaining weight loss can be difficult.

"Weight loss is only part of the story," Boutelle said. "Our goal is to develop treatments that give adolescents and families skills they can continue to use after a structured program ends. Understanding how emotions influence eating may help us build interventions that are more sustainable for youth over the long term."

Publication details

Emotion-focused behavioral weight loss treatment for adolescents: A randomized clinical trial, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.39867

Journal information: JAMA Network Open

Key medical concepts

Emotional Eating

Clinical categories

PediatricsWeight managementChildren's healthPsychology & Mental healthPsychiatry Provided by University of California - San Diego Who's behind this story?

Swati Mestri

Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

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