The Development of An Eating Laboratory for Overweight Adolescents

描述（由申请人提供）：肥胖是美国儿童和青少年日益重要的问题。在过去的30年里，儿童和青少年中超重的患病率从5%上升到16%。它是一种与生物、环境和行为相关的复杂疾病，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消耗之间的不平衡引起的，而这些因素大多受行为控制。人类饮食行为本身是一种复杂的现象，人们对其了解甚少，在儿童和青少年中也没有进行充分的研究。然而，饮食行为显然会导致超重问题，而且是可以改变的。我们的团队在客观表征饮食行为、饮食相关感知和饮食相关激素方面有丰富的经验，这些都是患有饮食失调和肥胖的成年人。我们对神经性贪食症的饮食实验室研究已经确定，患有这种疾病的个体的饮食行为在客观上是异常的，其特征是胃排空减慢，餐后胆囊收缩素释放减少。这些发现导致了目前正在研究的创新治疗方法。这项R21申请是对PA-06-149“消化疾病和营养的创新和探索性研究”的回应，代表了一种新的和探索性的方法来治疗青少年肥胖。我们建议建立一个青少年饮食实验室，以检查治疗干预前后超重青少年的饮食行为和饮食相关激素。这个项目与美国国立卫生研究院肥胖研究战略计划是一致的，因为它弥合了我们对食物摄入的生物学基础知识和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理解青少年超重机制的新方法，以及这些机制如何受到治疗干预的影响。最终，这种方法应该允许更快地开发和评估超重青少年的治疗方法。来自此R21的数据将构成后续R01应用程序的基础。美国儿童和青少年超重是一个严重的公共卫生问题。这种疾病的病因是复杂的，但这种情况最终是由能量消耗和消耗之间的不平衡引起的，这些因素大多在行为控制之下，因此可能是可以改变的。饮食实验室允许仔细测量饮食行为和与饥饿和饱腹感相关的饮食相关激素，这对于检查这种情况的途径和理解超重青少年治疗的作用机制是有用的。

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.