Obesity [Body mass index (BMI kg/m2 ≥ 95th percentile)] affects 1 in 5 adolescents in the United States, with 13 million suffering from severe obesity (BMI ≥ 120% > 95th percentile or ≥ 35 mg/kg2). Adolescents are able to lose weight with behavioral changes in diet and physical activity, but change in these behaviors requires self-monitoring and support, and weight loss is not always successful.

Parent involvement and parent weight-loss can help their children to lose weight and successfully change their behavior. Guidance from pediatricians can also help to facilitate weight loss among obese adolescents. That said, treatment of obesity through behavior change within the time constraints of a Pediatric practice visit is limited by treatment adherence and clinic visit attendance. Therefore, finding cost-effective, timely, methods to keep adolescents with severe obesity engaged in therapy outside of standard practice is a critical need.

The effects of monetary incentives through games (gamification), and a comprehensive remote digital monitoring system on sleep, physical activity, and dietary intake, has been successful in adults, but has not been tested in adolescents with obesity.

Inclusion Criteria:

• Child Subjects age 10 - 16
• Obese as defined by body mass index (BMI)
• Computer access and data plan with text messaging
• SSB intake of 2 or more servings per day (1 serving=12oz)

Exclusion Criteria:

• Active substance abuse.
• Syndromic or secondary obesity.
• Any developmental disorder.
• Eating disorder (with the exception of binge eating disorder).
• Psychosis.
• Untreated depression.
• Use of medications (prescription or otherwise) known to effect body weight.
• Weight loss of more than 5% body weight in the past 3 months.
• History of bariatric surgery.