The Development of An Eating Laboratory for Overweight Adolescents

描述(申请人提供)：肥胖对美国儿童和青少年来说是一个越来越重要的问题。在过去的30年里，儿童和青少年超重的比例从5%上升到16%。它是一种复杂的疾病，与生物、环境和行为相关，并经常导致严重的医学和心理并发症。尽管我们对超重的生理、内分泌和遗传基础的理解已经取得了重大进展，但这种疾病最终是由能量消耗和支出之间的失衡引起的，这些因素大多受行为控制。人类进食行为本身是一种复杂的现象，人们对此知之甚少，也没有对儿童和青少年进行充分的研究。然而，饮食行为显然是造成超重问题的原因，而且可能是可以改变的。我们小组在客观描述患有饮食障碍和肥胖的成年人的饮食行为、与饮食相关的感知和与饮食相关的激素方面拥有丰富的经验。我们对神经性暴食症的饮食实验室研究证实，患有这种疾病的人的饮食行为客观上是异常的，其特征是胃排空减慢和餐后CCK释放减少。这些发现导致了目前正在研究的创新治疗方法。此R21应用程序是对PA-06-149“消化系统疾病和营养的创新和探索性研究”的响应，代表了一种针对青少年肥胖的新颖和探索性方法。我们建议建立一个青少年进食实验室，以检测超重青少年在治疗干预前后的饮食行为和与饮食相关的激素。该项目与NIH肥胖研究战略计划一致，因为它弥合了我们对食物摄入所涉及的生物学基础的了解与对人类肥胖行为影响的理解之间的差距。我们的应用代表了一种新的方法来理解青少年超重的机制，以及这些机制是如何受到治疗干预的影响的。归根结底，这种方法应该能够更快地开发和评估超重青少年的治疗方法。此R21中的数据将构成以后R01应用的基础。美国儿童和青少年超重是一个严重的公共卫生问题。这种疾病的病因很复杂，但这种情况最终是由能量消耗和支出之间的失衡引起的，这些因素大多受行为控制，因此可能是可以改变的。饮食实验室允许仔细测量与饥饿和饱腹感相关的饮食行为和与饮食相关的激素，这可能有助于检查导致这种情况的途径，并了解治疗超重青少年的作用机制。

DESCRIPTION (provided by applicant): Obesity is an increasingly important problem for US children and adolescents. The prevalence of overweight among children and adolescents has increased from 5 percent to 16 percent in the past 30 years. It is a complicated disorder with biological, environmental, and behavioral correlates and often leads to serious medical and psychological complications. Although there have been major advances in our understanding of the physiologic, endocrine, and genetic bases of overweight, the disorder is ultimately caused by an imbalance between energy consumption and expenditure, factors that are mostly under behavioral control. Human eating behavior itself is a complex phenomenon that is poorly understood and has not been adequately studied in children and adolescents. Yet, eating behavior clearly contributes to the problem of overweight and is potentially modifiable. Our group has extensive experience in objectively characterizing eating behavior, meal-related perceptions, and meal-related hormones in adults with eating disorders and obesity. Our eating laboratory studies of bulimia nervosa have established that the eating behaviors of individuals with this disorder are objectively abnormal, and characterized by slowed gastric emptying and diminished post-prandial release of cholecystokinin. These findings have led to innovative treatment approaches now under examination. This R21 application is in response to PA-06-149 "Innovative and Exploratory Research in Digestive Diseases and Nutrition" and represents a novel and exploratory approach to adolescent obesity. We propose to develop an adolescent eating laboratory in order to examine the eating behavior and meal-related hormones of overweight adolescents before and after therapeutic interventions. This project is consistent with the Strategic Plan for NIH Obesity Research in that it bridges the gap between our knowledge about the biological underpinnings involved in food intake and an understanding of behavioral influences on human obesity. Our application represents a novel approach to understanding the mechanisms that underlie adolescent overweight and how these mechanisms are affected by therapeutic interventions. Ultimately, this approach should permit more rapid development and evaluation of treatments for overweight adolescents. The data from this R21 will form the basis for a later R01 application. Overweight in US children and adolescents is a serious public health problem. The etiology of the disorder is complex, but the condition is ultimately caused by an imbalance between energy consumption and expenditure, factors that are mostly under behavioral control, and thus potentially modifiable. The eating laboratory allows the careful measurement of eating behavior and meal-related hormones associated with hunger and fullness, which can be useful in examining pathways to this condition and understanding the mechanism of action of treatments for overweight adolescents.