# Integrating remote high-intensity interval training into multi-component obesity treatment for adolescents: Impacts on body composition, fitness, and lifestyle

PMID: 40396156
Journal: Obesity Pillars
Published: 2025-06
Authors: de Freitas F, Zago MR, Antônio MÂ, Brandão MÂB, Videira-Silva A

## Question

Does a remotely delivered HIIT program, integrated into standard multicomponent obesity treatment, improve body composition, physical fitness, and lifestyle measures in adolescents with obesity?

## Summary

A 3-month remote bodyweight HIIT program added to multidisciplinary obesity care for adolescents was feasible for adherent participants and was associated with lower BMI z-score, better flexibility and trunk endurance, and higher water intake among adherers, but it did not clearly improve fat mass or skeletal muscle mass.

## Population

- Adolescents with obesity in a Brazilian outpatient obesity clinic.
- Sample size: 100
- Age: 12-17 years
- Sex: Both sexes; experimental group 30% boys and control group 28% boys.
- Fitness level: Not reported as trained; clinical obesity population.
- Health status: BMI z-score >= 2; screened for clinical and cardiovascular limitations.

## Methodology

- Non-randomized controlled intervention with adherent, non-adherent, and control comparisons.
- 3 months
- Brazilian adolescent obesity outpatient clinic with HIIT delivered remotely by Google Meet.
- Controlled study design.

## Protocol

- Remote bodyweight HIIT.
- Modality: Bodyweight aerobic/resistance circuit.
- Work intervals: 40 s.
- Recovery: 10 s.
- Sets or repetitions: About 4 sets.
- Intensity: High perceived exertion.
- Session duration: About 20 min.
- Frequency: 4 sessions/week.
- Program length: 3 months.
- Progression: One-week acclimatization then progressive difficulty and intensity.
- Standard multidisciplinary obesity care.
- Modality: Pediatrician and nutritionist counseling.
- Program length: 3 months.

## Outcomes

### BMI z-score
Status: improved
BMI z-score decreased, with greater reduction among adherers than non-adherers and controls.

Time beta -0.08 p=0.001; adherers vs non-adherers beta -0.30 p<0.001; adherers vs control beta -0.29 p<0.001.

### Flexibility and trunk endurance
Status: improved
Flexibility and trunk flexion/core endurance improved after the intervention.

Flexibility beta 3.5 p<0.001; trunk flexion beta 2.9 p=0.002.

### Body fat and skeletal muscle mass
Status: no clear change
No significant changes were detected for body fat mass or skeletal muscle mass.

### Water intake
Status: improved
Water intake increased in adherent participants.

Beta 0.2 p=0.022.

## Practical Insights

- Remote HIIT for adolescents should include a gradual first week.
- Family support and home context may matter as much as protocol design for adherence.
- No-equipment bodyweight circuits can be delivered by video when cameras are available.

## Limitations

- Non-randomized design with selection bias risk
- Short single-center intervention
- Intensity was subjective rather than heart-rate verified
- Internet and camera access may limit generalizability
- HIIT was embedded in broader clinical obesity care

## Safety And Adherence

- No injuries or physical complications were reported.
- Participants were clinically screened before enrollment.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/40396156/) (pubmed)
- [DOI](https://doi.org/10.1016/j.obpill.2025.100176) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090249/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.