School absenteeism is a frequent but underrecognized consequence of adolescent obesity, with long-term implications for social and professional integration.

To assess changes in school attendance among adolescents with complex obesity before and after participation in a therapeutic residential care-study program (“soins-études”).

We conducted a retrospective cohort study including adolescents with complex obesity hospitalized for ≥3 months in a therapeutic residential care-study program at a clinic of the French Student Health Foundation (FSEF) between 2020 and 2022. Clinical, psychological, and socioeconomic data were collected at admission. School attendance was assessed at four time points: before hospitalization (T-1), at discharge (T), one year post-discharge (T + 1), and three school terms post-discharge (T + 3).

Eighty-one adolescents were included (mean age 14.6 ± 1.8 years; 54 girls). Prior to admission, 17 participants (21%) were out of school. This proportion decreased over time. At T + 1, six adolescents remained out of school, while ten had resumed schooling. At T + 3 (data available for 10 of the initially out-of-school adolescents), three remained out of school, while others had re-entered secondary education (n = 3), entered higher education (n = 2), begun an apprenticeship (n = 1), or enrolled in vocational training (n = 1). Higher baseline anxiety was significantly associated with persistent school dropout at T + 1.

Participation in a therapeutic residential care-study program was associated with improved school attendance trajectories among adolescents with complex obesity.