Background: Treatment-seeking adolescents with obesity may have diverse dietetic, psychological, or medical needs that require support during obesity treatment.

Objectives: To characterize initial referral reasons, content, and outcome of support visits provided in addition to protocolized visits during an obesity treatment trial.

Methods: The Fast Track to Health trial was a 52-week multi-site randomized trial conducted between 2018 and 2023 in Australia, comparing intermittent and continuous energy restricted dietary interventions delivered as part of an intensive behavioral intervention in adolescents with obesity and ≥1 obesity-related complications. Alongside protocolized mental health screening and medical and dietetic reviews, additional support was provided by the study dietitian, pediatrician or psychologist if needed or requested by families. Two reviewers independently coded deidentified clinical notes for each additional support visit to identify referral reasons, content and outcome of each visit.

Results: Of 141 adolescents enrolled, 51 (36.2%) attended at least one additional support session, with most (n = 31) having one visit. Most referrals were initiated by a clinician (n = 34) and included requests for dietetic review (n = 16), motivation and/or support during COVID-19 lockdowns (n = 15), general psychological review (n = 14) and anxiety (n = 11).

Conclusions: Understanding the diverse needs of adolescents with obesity is essential to inform obesity treatment interventions.