Many children and young adults in the U.S. attend weight-loss camps over the summer. Sometimes known as "fat camps," the goal of these programs is simple: lose weight while having fun. Most campers report significant weight loss and having had a positive experience.

However, what differentiates good weight-loss camps from less effective weight-loss camps is not only the quality of the facilities, the food and the staff, but whether the camp experience leads to long-term behavioral change.

Good weight-loss camps direct their entire programs at changing behavior over the long term. Sports, activities, educational and clinical programs are all part of an overall clinical design to teach new behaviors and habits. Cognitive behavioral therapy is likely a core element of the clinical program. And because it is unlikely that a child's behavior will change completely over the course of a summer, let alone one month in the summer, good weight-loss camps will provide follow-up or after-care programs, checking in with kids and their families. Exceptional camps may try to involve families towards the end of the camp experience in an attempt to change the environment into which the child is returning. Some new camps are acting as feeders into residential schools, which enroll students for 6 months or longer - a length of time that is likely to allow for substantial behavioral change.

Other weight-loss camps are more oriented towards short-term weight loss. Portion sizes are reduced. Diet is changed. The activity level is high. But there is effectively no overall clinical model that will effect long-term behavioral change. Frequent weighing is a hallmark of less effective programs. While weighing can be a boost to morale over the summer, it will not be a constructive habit for a child whose behavior has not otherwise changed once he or she returns home.

So if you're thinking about weight-loss camp this summer, think about asking these questions:

- How would you describe the clinical program?
- How does it engender long-term behavioral change?
- Who designed the clinical program?
- Who is the clinical director, monitoring the effectiveness of the program?
- Can I see outcomes data? (Blinded data is fine.)
- Is there an after-care program?
- How are families involved?
- Do you refer campers to residential school programs?