Testing the feasibility and preliminary efficacy of a psychological and behavioral intervention to promote physical activity after weight loss surgery

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PROJECT SUMMARY/ABSTRACT Candidate. This administrative supplement will allow Dr. Feig to continue toward her path of becoming an independent investigator with expertise in developing and testing evidence-based interventions to improve health and well-being in patients with obesity. Her achievements thus far demonstrate her promise as a clinical researcher (39 peer-reviewed publications), and with the additional training and mentorship she is receiving through this K23 award she will contribute significantly to efforts to reduce the burden of obesity and improve quality of life for those with obesity. Training Plan. Dr. Feig will continue with her proposed training plan after her return from maternity leave, which will be possible with the additional support that will free up for time for her to focus on training. This will include attending ongoing research seminars at Massachusetts General Hospital, meeting regularly with her mentors, Dr. Huffman, Dr. Thorndike, Dr. Psaros, and Dr. Healy, and continuing to participate in the Harvard Catalyst GRASP Program. She will also, as planned, take the three-day Blackburn Course in Obesity Medicine, apply for the ORBIT Institute Developing Behavioral Treatments to Improve Health NIH-funded short course in the spring of 2024, and will take an RCR refresher course. Background. Metabolic/bariatric surgery is the most effective treatment available for severe obesity, yet about 25% of patients do not achieve sustained meaningful weight loss after surgery. Both adherence to health behaviors such as physical activity and psychological well-being are associated with weight loss maintenance after surgery, but up to 90% of patients do not meet physical activity recommendations post-surgery. A lack of psychological well-being may contribute to low levels of physical activity, especially if patients have negative emotional associations with physical activity. Interventions that consider this psychological component are needed to improve physical activity adherence in patients after metabolic/bariatric surgery who are struggling to exercise consistently. Research Strategy. To address this gap, this K23 study is using a mixed methods design to adapt and test a positive psychology-motivational interviewing physical activity intervention in patients post-surgery from the Massachusetts General Hospital Weight Center. After completing qualitative interviews with 23 patients to better understand emotional experiences related to physical activity and a proof-of-concept trial (N=12) of the newly adapted intervention based on these interviews, a pilot randomized controlled trial is currently in progress (target N=58) to test feasibility, acceptability, and preliminary efficacy of the intervention. The proposed administrative supplement will allow this trial to continue to run efficiently during and after Dr. Feig’s maternity leave to meet recruitment goals, laying the groundwork for an R01 application to test efficacy of the intervention in a full-scale trial.