Does aberrant decision-making prevent success in adolescent behavioral weight loss treatment?

项目概要/摘要 此K23应用程序旨在支持Stephanie Manasse博士实现其成为 独立的临床研究人员专注于开发和评估肥胖症的新疗法。的 拟议的应用程序将通过提供高级培训来加强候选人实现这一目标的能力： (1)获得理论模型和决策测量方面的专业知识;（2）发展以下方面的专业知识： 营养和膳食模式分析;（3）设计和执行青少年肥胖的临床试验;（4）建立 熟练掌握与临床试验研究相关的多层次和纵向数据分析方法。到 为了实现这些目标，已经组建了一个由导师组成的专家团队，由主要导师Evan博士组成 Forman（进行肥胖症临床试验）;共同导师Adrienne Juarascio博士（进行 饮食失调个体的临床试验），约瑟夫·凯布尔博士（用于模型和测量培训 Tanja Kral博士（用于儿童肥胖症的膳食模式和营养分析培训）， Tanofsky-Kraff（青少年肥胖和失控的评估和临床试验方法培训 饮食）和Zoe Zhang博士（纵向统计方法培训）;以及顾问Robert Berkowitz（青春期体重和体重变化的生物学考虑）和Laurence Steinberg博士 (for青少年决策模式培训）。 作为本次培训的一部分，Manasse博士将完成一个项目，该项目将研究 异常的决策过程（即，延迟折扣，情感驱动的冲动，和毅力 决策）在青少年肥胖行为治疗的减肥结果。第二，研究 还将研究异常决策对治疗期间有问题的饮食行为的影响 这些因素可能导致减肥效果不佳：奖励驱动的暴饮暴食，饮食失控， 饮食限制问题。第三，这项研究将检查这些有问题的饮食行为是否 介导异常决策对减肥结果的影响。我们将招募60名青少年 (ages 14-18）（n=30）和无（n=30）临床显著厌食症，将完成行为 减肥计划和完整的基线决策措施。有问题的饮食行为， 将在治疗中期（6周）、治疗后（16周）、6个月随访时， 和12个月随访。目前的研究将提供关键信息，直接导致 开发一种新的青少年肥胖干预措施， 决策和改善减肥结果。考虑到减肥治疗的效果不佳， 对于青少年，有必要针对青少年独特的发展因素进行新的增强。 因此，除了帮助启动候选人进入独立的研究生涯，这个项目将 通过为青少年肥胖治疗开发提供急需的知识来满足关键需求。

PROJECT SUMMARY/ABSTRACT This K23 application aims to support Dr. Stephanie Manasse in her overarching goal of becoming an independent clinical researcher focused on developing and evaluating novel treatments for obesity. The proposed application will strengthen the candidate’s ability to meet this goal by providing advanced training to: (1) Gain expertise in theoretical models and measurement of decision-making; (2) develop expertise in nutritional and meal pattern analysis; (3) design and execute clinical trials for adolescent obesity; (4) Build proficiency with multilevel and longitudinal data analytic approaches related to clinical trial research. To achieve these goals, an expert team of mentors has been assembled, consisting of primary mentor Dr. Evan Forman (for conducting obesity clinical trials); co-mentors Dr. Adrienne Juarascio (for training in conduct of clinical trials for individuals with disordered eating), Dr. Joseph Kable (for training in models and measurement of decision-making), Dr. Tanja Kral (for training in meal pattern and nutritional analysis in pediatric obesity), Dr. Tanofsky-Kraff (for training in assessment and clinical trial methods in adolescent obesity and loss-of-control eating) and Dr. Zoe Zhang (for training in longitudinal statistical methods); and consultants Dr. Robert Berkowitz (biological considerations of adolescence on weight and weight change) and Dr. Laurence Steinberg (for training in models of adolescent decision-making). As part of this training, Dr. Manasse will complete a project that will examine the predictive role of aberrant decision-making processes (i.e., delay discounting, affect-driven impulsivity, and perseverative decision-making) in weight loss outcomes from behavioral treatment for adolescent obesity. Second, the study will also examine the influence of aberrant decision-making on problematic eating behaviors during treatment that are likely driving poor weight loss outcomes: reward-driven overeating, loss-of-control eating, and problematic dietary restriction. Third, the study will examine whether these problematic eating behaviors mediate the influence of aberrant decision-making on weight loss outcomes. We will recruit 60 adolescents (ages 14-18) with (n=30) and without (n=30) clinically significant LOC eating who will complete a behavioral weight loss program and complete measures of decision-making at baseline. Problematic eating behaviors and weight outcomes will be evaluated at mid-treatment (6 weeks), post-treatment (16 weeks), 6-month follow-up, and 12-month follow-up. The current study will provide critical information that will directly lead into the development of a novel adolescent obesity intervention augmentation that will be poised reduce aberrant decision-making and improve weight loss outcomes. Given the poor efficacy of weight loss treatments in adolescents, novel augmentations that target the unique developmental factors of adolescence are necessary. Therefore, in addition to helping launch the candidate into an independent research career, this project will meet a critical need by providing much-needed knowledge for adolescent obesity treatment development.