Behavioral Phenotypes of Reward and Inhibition in Parent-Child Weight Loss

摘要 大约三分之一的儿童和三分之二的成年人患有超重或肥胖。至 迄今为止，最成功的儿童减肥治疗是以家庭为基础的儿童肥胖治疗（FBT）， 将营养和体育活动教育与行为治疗策略和家长相结合 旨在塑造儿童和父母健康行为的管理技术。不幸的是，并非所有 孩子和家长做出了反应，大多数人的体重恢复了大部分或全部。面临的挑战之一 试图控制体重的家庭现在的饮食环境充满了高热量， 享乐的、低成本的食物使得人们很容易吃到超出营养需求的食物。很有可能 减肥计划失败是因为目前的治疗方法没有充分针对基本认知机制 本质上涉及个人如何与当前食品环境互动。暴饮暴食或吃过去 营养需求，理论上是两种基本认知机制相互作用的结果； 来自食物的生理和心理奖励以及抑制暴饮暴食的能力。我们有 开发了一些针对特定食品的认知评估，针对以下人群的特定脆弱性： 有超重和肥胖。对于这个项目，我们建议添加奖励和抑制的评估 包括参与两个 R01 的 260 对父母/孩子的自我报告和基于任务的测量 评估 6 个月 FBT 计划的项目。评估将在基线、6 个月、12 个月和 24 个月时进行 时间点。本研究的主要目的是 1) 确定行为和心理表型 儿童和父母基线的奖励和抑制，2) 评估这些表型是否预测 儿童和父母在 6、12 和 24 个月时间点的体重减轻。我们还将比较行为 以及父母和孩子之间奖励和抑制的心理表型，我们将1）评估 孩子和父母奖励和抑制表型之间的相互作用是否可以预测体重变化 6、12 和 24 个月的时间点，2) 评估养育方式是否与孩子的行为和行为相互作用 奖赏和抑制的心理表型，3）探索行为和心理是否 儿童和父母基线时确定的表型随着时间的推移而变化，以及这些变化是否是 与儿童和父母的体重减轻有关。该项目将收集有关奖励的重要且独特的数据 参与 FBT 计划的儿童和家长的认知和抑制方面。这些数据将 允许识别超重和肥胖儿童的特定认知表型及其 父母，并最终开发出对特定群体更有效的有针对性的治疗方法 孩子和父母。

ABSTRACT Approximately one out of every three children and two out of every three adults have overweight or obesity. To date, the most successful treatment for child weight loss is family-based treatment for childhood obesity (FBT), which combines nutrition and physical activity education with behavior therapy strategies and parent management techniques targeted to shape healthy behaviors in both the child and parent. Unfortunately, not all children and parents respond and the majority regain most or all of their weight back. One of the challenges for families attempting to manage their weight is the current food environment, which is replete with high calorie, hedonic, low cost foods which make it incredibly easy to eat beyond nutritional needs. It is very possible that weight loss programs fail because current treatments inadequately target basic cognitive mechanisms that are inherently involved in how individuals interact with the current food environment. Overeating, or eating past nutritional needs, is theorized to be a result of the interaction between two basic cognitive mechanisms; physiological and psychological reward from food and the ability to inhibit impulses to overeat. We have developed a number of food-specific cognitive assessments which target specific vulnerabilities in people who have overweight and obesity. For this project, we propose to add assessments of reward and inhibition that include both self-report and task-based measurements among 260 parent/child pairs participating in two R01 projects evaluating 6-month FBT programs. Assessments will be conducted at baseline, 6-, 12- and 24-month timepoints. The primary aims of this study are 1) to determine behavioral and psychological phenotypes of reward and inhibition at baseline in children and parents and 2) to evaluate whether these phenotypes predict weight loss in both children and parents at 6-, 12- and 24-month timepoints. We will also compare behavioral and psychological phenotypes of reward and inhibition between parents and children, and we will 1) evaluate whether the interaction between child and parent phenotypes of reward and inhibition predict weight change at 6, 12- and 24-month timepoints, 2) evaluate whether parenting style interacts with child behavioral and psychological phenotypes of reward and inhibition, and 3) explore whether the behavioral and psychological phenotypes identified at baseline in children and parents change over time and whether these changes are associated with weight loss in children and parents. This project will collect crucial, unique data on both reward and inhibition aspects of cognition, in both children and parents participating in an FBT program. These data will allow the identification of specific cognitive phenotypes in children with overweight and obesity and their parents, and ultimately to develop targeted treatments that could be more effective with specific groups of children and parents.