Predicting Weight Regain Following Weight Loss Using Physiological Measures of Appetite and Energy Expenditure

项目总结 行为减肥计划的成功会因为体重恢复而受到影响。争议 对减重状态的生理适应在多大程度上有助于 体重又恢复了。此外，人们对复发的相对贡献知之甚少。 新陈代谢效率和食欲增强。即使代谢效率随着 减肥，这并不一定意味着成功的节食者体内代谢不足。 体重减轻状态。为了解决这些科学问题，我们将招募100名个人参加一个 减肥计划基于糖尿病预防计划的修改版本。合格 参与者将在基线时接受评估，如果他们的体重达到最低7%，将进行重新评估 损失(称为0个月)，并在2个月和18个月后进行随访评估。 第二个月的重新评估将使我们能够将向维护的过渡作为一种动态研究 流程(即，从0个月更改为2个月)，而不仅仅是状态的离散更改(从基线更改为 月)。由33名体重稳定的超重个体组成的对照组，与成功的 体重指数和其他变量的减肥者将在时间0被招募，并与体重进行比较 在所有结果指标上都是输家。新陈代谢生理指标的变化和 减肥期间的食欲将被用来预测体重恢复的个体差异。通过 比较体重减轻和体重稳定的个体，我们将制定一个独特的参照点 用于解释组内预测分析的结果。生理结局 措施将包括：1)能量代谢(例如，静息和非静息能量消耗， 2)食欲驱动的神经指标(例如，纹状体对食物暗示和食物味道的激活)和 3)对空腹和进食状态的神经内分泌反应(如瘦素、GLP-1)。一个全面的 还将收集血液、粪便、肌肉和脂肪组织的生物库，以供将来发现 学习。我们的测量方法和专业知识将提供对生理决定因素的新见解 减肥后体重恢复的比例，这可能有助于改善未来的肥胖治疗。

PROJECT SUMMARY The success of behavioral weight loss programs is undermined by weight regain. Controversy exists about how much physiological adaptations to the weight reduced state contribute to weight regain. Further, little is known about the relative contributions to relapse of increased metabolic efficiency and increased appetitive drive. Even if metabolic efficiency increases with weight loss, this does not necessarily mean that successful dieters are hypo-metabolic in their weight-reduced state. To address these scientific questions, we will recruit 100 individuals into a weight loss program based on a modified version of the Diabetes Prevention Program. Qualified participants will be assessed at baseline and reassessed if they attain a minimum 7% weight loss (called month 0) and undergo follow-up assessments 2 and 18-months later. Reassessment at month 2 will allow us to study the transition to maintenance as a dynamic process (i.e., change from month 0 to 2), not just as a discrete change of state (from baseline to month 0). A control group of 33 weight-stable overweight individuals, matched to successful weight losers on BMI and other variables, will be recruited at time 0 and compared to weight losers on all outcome measures. Changes in physiological measures of metabolism and appetite during weight loss will be used to predict individual differences in weight regain. By comparing weight-losing to weight-stable individuals, we will develop a unique reference point for interpreting the results of the within-group predictive analyses. Physiological outcome measures will include: 1) energy metabolism (e.g., resting and non-resting energy expenditure, 2) neural indicators of appetitive drive (e.g., striatal activation to food cues and food tastes) and 3) neuroendocrine responses to fasting and fed states (e.g., leptin, GLP-1). A comprehensive biobank of blood, fecal, muscle and adipose tissue will also be collected for future discovery studies. Our measures and expertise will provide new insight into the physiological determinants of weight regain following weight loss that could help improve obesity treatments in the future.