A remote-based yoga intervention for improving long-term weight loss

项目摘要 具有强大传播潜力的有效干预措施对于解决肥胖流行病至关重要。 互联网提供的减肥（IDWL）计划克服了许多常见的面对面的障碍， 干预（例如，地理限制，缺乏儿童保育，成本高），但体重减轻大约是 在现场治疗中观察到的一半。改善长期减肥（WL）的新方法 在IDWL方案中，需要。瑜伽已被发现是一种有效的策略，用于治疗各种各样的疾病。 健康状况（例如，心血管疾病的危险因素，抑郁症，疼痛综合征），但在很大程度上被忽视， 肥胖管理的背景。瑜伽也被证明可以加强自我调节技能（例如， 情绪调节、认知调节和自我相关过程），这些对于保持WL关闭非常重要 长期的尽管如此，迄今为止只有两项随机试验将瑜伽和行为WL治疗相结合。 虽然研究结果最初是有希望的，但重大的局限性包括缺乏对照组和样本量小 在一项研究中，研究人员对患者进行了短期随访（12周）。同时，瑜伽影响 体重管理计划中的WL尚未被探索。在我们的试点研究中，我们发现， 三个月的行为WL治疗后的瑜伽导致对饮食失误的有利影响（即，离散 威胁WL的饮食不依从发作），改善情绪，并提高抵抗饮食依赖的能力。 与接触匹配的对照相比，此外，瑜伽对WL有显著影响， 自我调节的措施（痛苦容忍度，正念和自我同情）在个人谁失去了 在治疗的前三个月内体重增加。坚持瑜伽干预，保留， 方案满意度很高。拟议的试验扩大了这些有希望的初步发现 通过增加瑜伽治疗的时间（3到9个月），在更长的18个月内评估参与者， 扩大参与者的特征（包括男性和增加种族/民族多样性）， 增加样本量，以便有足够的把握度来检查主要（WL）和次要结局 （饮食失误和其他可能引发饮食失误的不舒服经历）。 此外，它试图通过正式评估机制来填补文献中的一个重要空白， 瑜伽影响WL。所有个人将接受为期12个月的互联网交付WL计划，并将 在第3个月结束时随机分为9个月的瑜伽课程（通过视频会议提供）或9个月的瑜伽课程。 健康和保健计划（接触匹配对照）。受试者将被随访6个月， 治疗结束（18个月时的最终评估）。这项完全远程的试验有很大的潜力影响到 瑜伽和体重控制领域，特别是相关的新兴研究表明，许多 个人现在更喜欢在线健康护理程序而不是亲自程序。

PROJECT SUMMARY Effective interventions with strong dissemination potential are critical for addressing the obesity epidemic. Internet-delivered weight loss (IDWL) programs overcome many of the barriers common to face-to-face interventions (e.g., geographical constraints, lack of childcare, high cost), but weight losses are approximately half of that observed within in-person treatment. Novel approaches for improving long-term weight loss (WL) within IDWL programs are needed. Yoga has been found to be an effective strategy for treating a variety of health conditions (e.g., CVD risk factors, depression, pain syndromes), but has been largely overlooked within the context of obesity management. Yoga has also been shown to strengthen self-regulatory skills (e.g., emotion regulation, cognitive regulation, and self-related processes) which are important for keeping WL off long-term. Nonetheless, only two randomized trials to date have combined yoga and behavioral WL treatment. While findings are initially promising, significant limitations include a lack of a control group and small sample size in one study and a short follow-up (12 weeks) in the other. Also, mechanisms through which yoga impacts WL within a weight management program have not been explored. In our pilot study, we found that providing yoga following three months of behavioral WL treatment led to favorable effects on dietary lapses (i.e., discrete episodes of dietary non-adherence which threaten WL), improved affect, and increased ability to resist dietary temptations compared to a contact-matched control. Further, yoga had a significant effect on WL and measures of self-regulation (distress tolerance, mindfulness, and self-compassion) among individuals who lost more weight within the first three months of treatment. Adherence to the yoga intervention, retention, and program satisfaction ratings were high. The proposed trial expands upon these promising preliminary findings by increasing the length of yoga treatment (3 to 9 months), assessing participants over a longer, 18-month period, broadening participant characteristics (including men and increasing racial/ethnic diversity), and increasing the sample size, so that it is sufficiently powered to examine primary (WL) and secondary outcomes (dietary lapses and other uncomfortable experiences which could trigger a dietary lapse) at 12 months. Further, it seeks to fill an important gap in the literature by formally assessing the mechanisms through which yoga impacts WL. All individuals will receive a 12-month Internet-delivered WL program and will be randomized at the end of month 3 to a 9-month yoga program (delivered via videoconference) or 9-month health and wellness program (contact-matched control). Participants will be followed for 6 months beyond the end of treatment (final assessment at 18 months). This fully remote trial has great potential to impact both the yoga and weight control fields and is particularly relevant given emerging research indicating that many individuals now prefer online healthcare programs vs. in-person programs.