Targeting food cue responsiveness for weight loss

针对减肥的食物线索反应

• 批准号: 10466833
• 负责人: Kerri N Boutelle
• 金额: $ 68.17万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10466833
• 关键词: Adult; Aftercare; Awareness; Behavior; Behavior Therapy; Behavioral; Body Weight decreased; Body mass index; Cognition; Coping Skills; Cues; Data; Desire for food; Eating; Education; Effectiveness; Energy Intake; Environment; Exhibits; Exposure to; Failure; Food; Goals; Gold; Hunger; Hyperphagia; Individual; Laboratories; Maintenance; Measures; Mediator of activation protein; Medical; Modeling; Monitor; Obesity; Overweight; Participant; Pathway interactions; Patient Self-Report; Perception; Phenotype; Physical activity; Predisposition; Protocols documentation; Psychophysiology; Randomized; Randomized Controlled Trials; Regulation; Research; Risk Factors; Satiation; Techniques; Testing; Time; Training; Treatment Efficacy; Weight; acceptability and feasibility; active comparator; adult obesity; arm; base; behavioral phenotyping; clinical decision-making; craving; cue reactivity; demographics; design; dietary restriction; eating in absence of hunger; efficacy testing; follow-up; improved; novel; nutrition; obesity treatment; programs; psychoeducation; psychologic; recruit; response; skills training; standard care; success; targeted treatment; theories; therapy development; trait; treatment arm; treatment effect; treatment group; treatment program; weight loss intervention; weight loss program

ABSTRACT Two out of every three adults has overweight or obesity, which is associated with significant medical and psychological consequences. To date, the most successful weight loss treatment is behavioral weight loss (BWL), which includes nutrition and physical activity education, as well as behavior therapy techniques. Although some adults lose weight in these programs, one third to one half do not respond with even bleaker rates of weight loss maintenance over time. These low success rates suggest that there are underlying mechanisms, such as appetitive traits, that may interfere with response to BWL and underscore the critical need to develop targeted models for the treatment of obesity. Our data suggest that high food responsiveness (FR) is a risk factor for failure in BWL. We have developed a new model for the treatment of obesity based on the Behavioral Susceptibility Theory, called Regulation of Cues (ROC), that focuses on decreasing FR and improving satiety responsiveness (SR). In this study, we propose to recruit adults with overweight and obesity who also exhibit high levels of FR to test the efficacy of an enhanced ROC treatment program (ROC+) for this specific behavioral phenotype. We propose a 3 arm randomized controlled trial that will compare ROC+, BWL and an active comparator (AC). We will recruit and randomize 300 adults with overweight and obesity and will assess them at baseline, during treatment, post-treatment, and at 6- and 12-month follow-up. Primary and secondary aims are as follows. Primary Aim 1: Compare ROC+ to AC on body mass index (BMI) over the course of treatment and follow-up. Primary Aim 2: Compare ROC+ to BWL on body mass index (BMI) over the course of treatment and follow-up. Secondary Aim 1: Compare BWL to AC on body mass index (BMI) over the course of treatment and follow-up. Secondary Aim 2: Compare ROC+, BWL and AC on sensitivity to satiety, sensitivity to food cues, inhibition, restriction, caloric intake, and overeating over the course of the treatment and follow-up. Exploratory aim 1: Evaluate effects of mediators (FR, SR, restriction, overeating) and moderators (demographics, baseline BMI) of treatment effects on weight loss over time. This program of research is an important next step in the development of treatments for specific phenotypes of adults with overweight/obesity, and could change the paradigm of obesity treatment for these individuals. This study will contribute to the study of appetitive phenotypes of obesity, will provide a targeted treatment for individuals with high FR, and could inform clinical decision making for adults with obesity.

摘要 每三个成年人中就有两个超重或肥胖，这与重大的医学和 心理上的后果。迄今为止，最成功的减肥疗法是行为减肥。 (BWL)，包括营养和身体活动教育，以及行为治疗技术。 尽管一些成年人在这些计划中减肥，但三分之一到一半的人对更悲观的减肥没有反应。 随着时间的推移，保持减肥的速度。这些低成功率表明存在潜在的 机制，如食欲特征，可能会干扰对BWL的反应，并强调关键 需要开发治疗肥胖症的有针对性的模式。我们的数据表明，高度的食物响应性 (FR)是BWL失败的风险因素。我们开发了一种新的肥胖症治疗模式，基于 行为易感性理论，称为线索调节(ROC)，专注于降低FR和 改善饱腹感反应(SR)。在这项研究中，我们建议招募超重和肥胖的成年人 世卫组织也表现出高水平的FR，以测试增强的ROC治疗计划(ROC+)对此的疗效 特定的行为表型。我们提出了一项3组随机对照试验，将ROC+，BWL 和有源比较器(AC)。我们将招募和随机选择300名超重和肥胖的成年人，并将 在基线、治疗期间、治疗后以及6个月和12个月的随访时进行评估。主要和 次要目标如下。主要目标1：比较ROC+和AC在以下方面的体重指数(BMI 疗程和随访。主要目标2：比较ROC+和BWL在体重指数(BMI)方面 疗程和随访。第二目标1：比较体重指数(BMI)和体重指数(BMI) 疗程和随访。次要目标2：比较ROC+、BWL和AC对饱腹感的敏感性， 在治疗过程中对食物提示、抑制、限制、卡路里摄入量和暴饮暴食的敏感性 以及后续行动。探索性目标1：评估介质(FR、SR、限制、暴饮暴食)和 随着时间的推移，治疗对减肥效果的调节因素(人口统计学，基线BMI)。这是一项 研究是开发针对特定表型成年人的治疗方法的重要下一步。 超重/肥胖，并可能改变这些人的肥胖治疗模式。这项研究将 有助于研究肥胖的食欲表型，将为患有肥胖症的个体提供有针对性的治疗 高FR，并可为成人肥胖患者的临床决策提供信息。