Response: In Situ Mobilization of Patients with Obesity as a Key Determinant of Weight Loss Interventions (J Obes Metab Syndr 2020;29:292-302)

J Obes Metab Syndr 2022;31:88-90 While there is a growing body of evidence regarding the metabolic, physiological, or functional benefits of multi-disciplinary weight loss interventions in adolescents who are overweight and obese, their effects on mental health, well-being, health-related quality of life (HRQOL), and perceived physical-fitness and health remain less explored. Our research group recently tried to better understand these potential psycho-physiological responses to multi-disciplinary weight loss programs by considering different modalities of exercise interventions in obese adolescents.1 In particular, we recently reported in Journal of Obesity & Metabolic Syndrome, that a 4-month multi-disciplinary intervention incorporating high-intensity interval training improved HRQOL and perception of health and physical fitness in obese adolescents, and that most of these improvements were associated with degree of weight loss.2 In an Letter to the Editor, Choi3, while pointing out the quality and relevance of our work and its results, also stressed the necessity to fully consider the nature of the psychological support received by the adolescents, as well as the potential implication of their initial motivation when engaging in such interventions. We would like to thank Choi3 for raising these important points, giving us the opportunity to complete our initial publication, and to initiate what we believe are necessary discussions regarding the role and implications of adolescent (and overall patients) motivation and engagement in clinical interventions. First, the psychological intervention the adolescents received a monthly 90-minute session of psychological support through individual consultations with a professional. Sessions focused on selfesteem and emotional, social, and familial relationships and issues. As suggested by Choi3, psychological sessions can focus on motivation of patients to engage in the intervention efforts and to lose weight, which will impact their engagement with the program and affect the success of the intervention. However, our sessions mainly focused on coping with social and emotional difficulties that often accompany pediatric obesity. In his paper, Choi3 describes the importance of considering patient motivation, adherence, and engagement for intervention success. We agree and would like to take advantage of this opportunity to explore these concepts and clarify their potential implication for success of behavioral and clinical programs. Second, it seems important to clarify that our initial published