Barriers to weight management in adolescence: Measure adaptation among adolescents presenting to an interdisciplinary weight management clinic

A range of barriers may negatively impact adolescents' ability to successfully alter or sustain healthy weight-related behaviors. However, there is a lack of validated measures to empirically assess these barriers. This study developed a measure of adolescent-reported barriers to healthy weight-related behaviors by adapting the previously validated parent-report Barriers to Child Weight Management. Adolescents (N = 154) ages 11-17 presenting to a tertiary weight management program completed Barriers to Weight Management in Adolescence (BWMA). This measure assessed adolescents' perspectives of barriers to healthy weight-related behaviors. Confirmatory factor analysis was used to examine model fit, with four hypothesized subscales-Parental Disengagement, Cost, Lack of Family Support, and Adolescent Disengagement. Overall, good model fit was model demonstrated, chi(2) (98) = 130.44, p = .02, CFI = .92, RMSEA = .05, SRMR = .06, supporting a four-factor structure. A final 16-item measure demonstrated good initial psychometric properties. As hypothesized, BWMA was significantly associated with general healthy habits [r = -.25, 95% CI(-.46, -.12)] and parent-reported barriers [r = .40, 95% CI (.264, .586)]. This study adapted and tested preliminary validation of a quantitative measure of adolescent-reported barriers to weight-related behaviors. Identification of barriers may prompt providers to adequately assess, and in turn address, factors impeding adolescents' success in modifying eating and physical activity patterns.