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

摘要 大约每三个孩子中就有一个超重或肥胖，每三个成年人中就有两个超重或肥胖。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症治疗(FBT)， 它将营养和体育锻炼教育与行为治疗策略和家长 旨在塑造孩子和父母健康行为的管理技术。不幸的是，并不是全部 孩子和父母做出了反应，大多数人的体重恢复了大部分或全部。面临的挑战之一是 试图控制体重的家庭是目前的食物环境，充满了高卡路里， 享乐的，低成本的食物，这使得人们在营养需要之外吃起来非常容易。很有可能 减肥计划失败是因为目前的治疗方法不足以针对基本的认知机制，这些机制是 与生俱来地参与个体如何与当前的食物环境互动。暴饮暴食，还是吃过去了？ 营养需要，理论上被认为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冲动的能力。我们有 开发了一系列针对特定食物的认知评估，目标是 超重和肥胖。对于这个项目，我们建议增加对奖励和抑制的评估 包括参与两个R01 260个父/子对的自我报告和基于任务的测量 评估为期6个月的FBT计划的项目。评估将在基线、6个月、12个月和24个月进行 时间点。这项研究的主要目的是1)确定行为和心理表型 儿童和父母基线时的奖赏和抑制；2)评估这些表型是否可以预测 在6个月、12个月和24个月的时间点上，儿童和父母的体重都有所下降。我们还将比较行为 以及父母和孩子之间奖赏和抑制的心理表型，我们将1)评估 儿童和父母的奖赏和抑制表型之间的交互作用是否能预测体重变化 6个月、12个月和24个月的时间点，2)评估父母教养方式是否与儿童行为和 心理表型的奖赏和抑制，以及3)探索行为和心理是否 在基线上确定的儿童和父母的表型随着时间的推移而变化，以及这些变化是否 与儿童和父母的体重减轻有关。该项目将收集关于这两个奖励的关键、独特的数据 以及认知的抑制方面，在参加FBT计划的儿童和父母中。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人群更有效的靶向治疗 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.