Managing temptation in obesity treatment: A neurobehavioral model of intervention strategies.
Managing temptation in obesity treatment: A neurobehavioral model of intervention strategies.
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DOI：
10.1016/j.appet.2015.09.035
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发表时间：
2016-01-01
期刊：
影响因子：
5.4
通讯作者：
Sherwood NE
中科院分区：
文献类型：
--
作者：
Appelhans BM;French SA;Pagoto SL;Sherwood NE
肥胖生活方式干预措施的减肥效果主要取决于持续坚持低能量饮食，而大多数饮食坚持失误都是由美味食物的诱惑引起的。生活方式干预的高无反应率和复发率表明，当前的诱惑管理方法对于大多数参与者来说可能是不够的。在这篇概念性综述中，我们讨论了在诱惑过程中出现并导致饮食依从性下降的三种神经行为过程（注意偏差、时间贴现和冷热移情差距）。描述诱惑的神经行为特征凸显了旨在克服诱惑的诱惑抵抗策略与寻求避免或尽量减少暴露于诱惑刺激的诱惑预防策略之间的重要区别。许多抵抗诱惑和预防诱惑的策略严重依赖于前额叶系统介导的执行功能，这些系统很容易受到压力、睡眠不足、甚至暴露于诱人刺激等常见事件的干扰。相比之下，承诺策略是一套手段，使个人能够通过限制未来的选择来管理诱惑，而不会对执行功能提出过高的要求。这些概念被综合在一个概念模型中，该模型根据诱惑管理方法对奖励处理的预期影响和对执行功能的依赖程度对诱惑管理方法进行分类。最后，我们讨论了我们的模型对于在未来生活方式干预中加强诱惑管理方法的影响，根据关键的个体差异变量调整这些方法，并为未来的研究提出了高度优先的主题。
Weight loss outcomes in lifestyle interventions for obesity are primarily a function of sustained adherence to a reduced-energy diet, and most lapses in diet adherence are precipitated by temptation from palatable food. The high nonresponse and relapse rates of lifestyle interventions suggest that current temptation management approaches may be insufficient for most participants. In this conceptual review, we discuss three neurobehavioral processes (attentional bias, temporal discounting, and the cold-hot empathy gap) that emerge during temptation and contribute to lapses in diet adherence. Characterizing the neurobehavioral profile of temptation highlights an important distinction between temptation resistance strategies aimed at overcoming temptation while it is experienced, and temptation prevention strategies that seek to avoid or minimize exposure to tempting stimuli. Many temptation resistance and temptation prevention strategies heavily rely on executive functions mediated by prefrontal systems that are prone to disruption by common occurrences such as stress, insufficient sleep, and even exposure to tempting stimuli. In contrast, commitment strategies are a set of devices that enable individuals to manage temptation by constraining their future choices, without placing heavy demands on executive functions. These concepts are synthesized in a conceptual model that categorizes temptation management approaches based on their intended effects on reward processing and degree of reliance on executive functions. We conclude by discussing the implications of our model for strengthening temptation management approaches in future lifestyle interventions, tailoring these approaches based on key individual difference variables, and suggesting high-priority topics for future research.