Addressing Body Image in Weight Management: An Overlooked Risk Factor for Poor Treatment Outcome Among Women

在体重管理中解决身体形象：女性治疗效果不佳的一个被忽视的风险因素

• 批准号: 10394348
• 负责人: KayLoni L. Olson
• 金额: $ 19.25万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10394348
• 关键词: Address; Adherence; Adult; Affect; Aftercare; Area; Athletic; Behavior; Behavior Therapy; Behavioral; Behavioral Weight Control; Body Image; Body Weight; Body Weight decreased; Body mass index; Calories; Clinical; Clinical Research; Cues; Data; Development; Diabetes Mellitus; Ecological momentary assessment; Education; Elements; Ensure; Environment; Ethnic Origin; Ethnic group; Exercise; Feedback; Female Adolescents; Focus Groups; Fostering; Future; Goals; Growth; Guidelines; Health; Health Care Costs; Hospitals; Hydrocortisone; Hyperphagia; Individual; Inflammation; Infrastructure; Intervention; Intervention Studies; Intervention Trial; Interventional Imaging; K-Series Research Career Programs; Lead; Life; Maps; Mediating; Medicine; Mentors; Mentorship; Methodology; Methods; Modeling; Obesity; Outcome; Overweight; Participant; Pathway interactions; Phase; Population Control; Positioning Attribute; Prediction of Response to Therapy; Protocols documentation; Public Health; Quality of life; Questionnaires; Race; Randomized; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Sampling; Scientist; Shapes; Stigmatization; Subgroup; Target Populations; Teenagers; Testing; Thinking; Thinness; Training; Training Programs; Treatment outcome; United States; Weight; Weight Gain; Weight maintenance regimen; Wing; Woman; Work; base; black women; clinically significant; depressive symptoms; design; diet and exercise; dietary; experience; follow-up; individual variation; innovation; patient oriented; pilot trial; programs; racial and ethnic; recruit; skills; social stigma; success; therapy development; treatment effect; weight loss intervention

Project Summary This Patient-Oriented Career Development Award (K23) is designed to promote the development of Dr. KayLoni Olson as an independent, clinical research scientist focused on developing interventions to address factors that contribute to individual variability and poor outcomes in behavioral weight management. Overweight and obesity remain a major threat to public health and contribute significantly to health care costs in the United States. Standard behavioral weight management (SBT) facilitates clinically significant weight loss for many individuals but there is variability in treatment outcome. High weight and shape concern (WSC) is associated with less weight loss among women in behavioral weight management. One potential explanation for this relationship is that individuals with High WSC have more frequent negative thoughts about weight/shape which lead to overeating episodes. We therefore propose to use the Obesity-Related Behavioral Intervention Trials guidelines to refine an empirically-supported WSC treatment (the Body Project: BP) to increase suitability for adult women with overweight or obesity and enhance treatment effects. The protocol will be iteratively refined using exploratory sequential mixed methodology to more powerfully target WSC among women with overweight or obesity and to ensure acceptability to the target sample (Aim 1). The revised protocol will be tested in a randomized pilot trial to evaluate effects when combined with SBT (Aim 2). For the pilot trial, 60 women with overweight or obesity who report High WSC and want to lose weight will be recruited. They will be randomized to either a four-week WSC intervention (modified-BP) or a four-week, education-only control condition. All participants will then receive 24-week SBT. WSC and body weight will be assessed at baseline, 4 weeks, and after 24 weeks of weight loss. EMA will be utilized to evaluate treatment effects on negative weight/shape-related thoughts and overeating episodes throughout treatment. To conduct this project the applicant will complete a rigorous, targeted training program to acquire key skills necessary for the success of the project and to prepare the applicant for independence as an obesity researcher. Key areas for growth including 1) behavioral intervention development, 2) obesity stigma as a contributor to WSC, 3) ecological momentary assessment, 4) advanced quantitative methods to assess treatment outcomes, moderating and mediating factors, and 5) professional development. This training will be conducted under the primary mentorship of Dr. Rena Wing, with co-mentors Drs. Rani Elwy, Rebecca Puhl, Graham Thomas, Shira Dunsiger, and contributor Dr. Meghan Butryn. The skills acquired map directly onto elements of the proposed project but also position the applicant to expand her program of research in innovative directions. This mentorship team, in combination with the infrastructure and resources available through The Miriam Hospital and the Weight Control and Diabetes Research Center, represent the ideal environment to accomplish the applicant’s training goals, foster professional development and establish the applicant’s autonomy as an independent clinical obesity researcher.

项目摘要 这个以患者为导向的职业发展奖（K23）旨在促进KayLoni博士的发展 奥尔森作为一个独立的，临床研究科学家专注于开发干预措施，以解决因素， 导致个体差异和行为体重管理的不良结果。超重和肥胖 仍然是对公共卫生的主要威胁，并对美国的医疗保健费用做出了重大贡献。 标准行为体重管理（SBT）促进了许多个体的临床显著体重减轻 但治疗结果存在变异性。高重量和形状关注（WSC）与较少 行为体重管理中的女性体重减轻。对这种关系的一个可能的解释是 具有高WSC的个体对体重/形状有更频繁的负面想法，这导致 暴饮暴食因此，我们建议使用肥胖相关行为干预试验指南 改进一种外科支持的WSC治疗（身体项目：BP），以增加对成年女性的适用性 超重或肥胖的患者，并增强治疗效果。该协议将使用 探索性顺序混合方法，以更有力地针对超重或肥胖妇女中的WSC， 肥胖，并确保目标样本的可接受性（目标1）。修订后的方案将在 随机试验，以评估与SBT联合使用时的效果（目的2）。在试点试验中，60名妇女 将招募报告高WSC且想要减肥的超重或肥胖者。他们将被随机分组 为期四周的WSC干预（改良BP）或为期四周的仅教育对照条件。所有 参与者将接受为期24周的SBT。将在基线、第4周和第5周评估WSC和体重， 在24周的减肥后。EMA将用于评价治疗对体重/体型相关阴性的影响 在整个治疗过程中的想法和暴饮暴食事件。为进行此项目，申请人将完成一份 严格的，有针对性的培训计划，以获得项目成功所需的关键技能，并准备 申请独立的肥胖研究者。增长的关键领域包括：1）行为 干预开发，2）肥胖污名作为WSC的贡献者，3）生态瞬时评估，4） 先进的定量方法来评估治疗结果，调节和中介因素，以及5） 专业发展。本次培训将在雷纳·温博士的主要指导下进行， 共同导师拉尼埃尔维博士，丽贝卡普尔，格雷厄姆托马斯，希拉邓西格，和贡献者梅根布特林博士。 获得的技能直接映射到拟议项目的元素，但也定位申请人扩展 她在创新方向的研究计划。这个指导团队与基础设施相结合， 和资源可通过米里亚姆医院和体重控制和糖尿病研究中心， 代表理想的环境，以实现申请人的培训目标，促进专业发展 并确立申请人作为独立临床肥胖研究者的自主权。