Abstract
BACKGROUND/OBJECTIVES: Adolescent girls with obesity often experience elevated sport-related anxiety and emotional eating, which impair both physical and psychological health. This study aimed to evaluate the effects of a didactically adapted basketball program on body mass index (BMI), emotional eating, sport-related anxiety, and technical performance in adolescent girls with moderate obesity. METHODS: In this two-arm, parallel-group randomized controlled trial, 64 participants aged 15-16 years were randomly assigned to an experimental group (EXP, n = 32), receiving a 7-week adapted intervention, or a control group (CONT, n = 32), following standard physical education sessions. Assessments included BMI, the Dutch Eating Behavior Questionnaire (DEBQ), the Sport Anxiety Scale-2 (SAS-2), and standardized passing and shooting drills, administered pre- and post-intervention under supervised and confidential conditions. RESULTS: The adapted program led to significant improvements in BMI (p < 0.001, d = 0.65), emotional eating (p = 0.0003, d = 0.74), and sport-related anxiety (p < 0.001, d = 0.95), as well as enhanced passing and shooting accuracy (p = 0.004 to < 0.001, d = 0.56-0.72). Reductions in anxiety and emotional eating were significantly correlated with gains in technical performance (r = -0.31 to -0.41, p < 0.01). CONCLUSIONS: Pedagogically adapted basketball sessions represent an effective and inclusive approach to enhance motor skills, regulate emotions, and improve body composition in adolescent girls with moderate obesity. These findings emphasize the value of progressive, emotionally supportive, and socially engaging physical education programs tailored to vulnerable adolescent populations.