# Comparison of Intensive Behavioral Counseling vs. Medical Management to Treat Adolescent Severe Obesity

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2021 · $659,445

## Abstract

Abstract
The prevalence of adolescent severe obesity is at an all-time high in the U.S. (~8%), and the refractory nature
of this disease has led to uncertainty regarding how to provide effective, safe, scalable, and durable treatments
without placing undue strain on the healthcare system. In 2017, the U.S. Preventive Services Task Force
(USPSTF) released updated screening recommendations concluding that comprehensive, intensive behavioral
interventions with a total of ≥26 contact hours over a period of 2-12 months resulted in weight loss in youth with
obesity, with ≥52 contact hours leading to even greater weight loss and improvements in some cardiometabolic
risk factors. However, the practicality of delivering these types of intensive behavioral services to the millions
of youth with severe obesity in the U.S. is debatable not only because of the treatment-resistant nature of
severe obesity, but also the time-commitment, acceptability, and sustainability of this approach for patients and
their families and the extensive resources required to offer these interventions. While behavior change is an
indispensable component of any effective weight loss approach, adjunctive strategies such as
pharmacotherapy may enhance health outcomes. Pharmacotherapy combined with relatively low-intensity
behavioral counseling (<26 contact hours) represents a potentially effective, durable, and safe treatment
strategy for this population. This approach may be more practical and feasible to implement on a broad scale,
preferred by patients and families, utilize fewer healthcare resources, and cost less to deliver compared to
comprehensive, intensive behavioral interventions. We propose a two-arm, randomized clinical trial in
adolescents with severe obesity evaluating two years of comprehensive, intensive behavioral counseling,
aligned with the USPSTF report (52 contact hours during year one; 26 contact hours during year two), vs. two
years of medical management with liraglutide plus relatively low-intensity behavioral counseling (12 contact
hours during year one; six contact hours during year two). Outcomes will include weight loss effectiveness and
durability, cardiometabolic risk factor improvements, quality of life, safety, and implementation feasibility.

## Key facts

- **NIH application ID:** 10215501
- **Project number:** 5R01DK123273-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Aaron S Kelly
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $659,445
- **Award type:** 5
- **Project period:** 2020-07-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10215501

## Citation

> US National Institutes of Health, RePORTER application 10215501, Comparison of Intensive Behavioral Counseling vs. Medical Management to Treat Adolescent Severe Obesity (5R01DK123273-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10215501. Licensed CC0.

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