Promoting Healthy Weight with "Stability First"

描述（由申请人提供）：尽管减肥有好处，但维持减肥的尝试是短暂的。一旦积极的维持干预结束，个人往往放弃生活方式和自我调节的变化，并恢复他们失去的体重。我们建议，个人需要学习一套新的稳定技能，优化目前的生活方式和自我调节习惯的满意度：（a）学会吃健康的饮食，更积极，而不觉得被剥夺（相对剥夺理论）和（B）学会调节或“微调”之间的平衡饮食，活动，和重量与最小的努力和注意力必要的（有限资源理论）。我们还建议，如果个人在开始减肥之前学习这些稳定技能，他们会更成功（即，稳定性第一），因此，利用初始动机，提供掌握，并增加自我效能，以在未来保持稳定的体重（社会认知理论）。目前的修订版将测试减肥前学习稳定技能是否能改善长期的体重管理（即，在随后的随访中）。在这项随机试验中，232名超重和肥胖的成年人将被随机分配到2种情况之一。在稳定技能条件下，个人将首先在3个月的预备模块中学习稳定技能，然后参加标准的6个月行为减肥计划。在对照条件下，个人将首先在3个月的预备模块中学习营养消费技能（参与者表现出兴趣，但与体重稳定和维持无关），然后参加与稳定技能相同的标准减肥计划。这两种情况下的参与者将在减肥计划后的12个月随访期间进行评估;在9个月的干预期间提供相同数量的课程;并将同时开始和完成6个月的减肥计划。将在基线、3、9、15和21个月时测量结局。主要目的是检查稳定技能个体（1a）在12个月随访期间体重增加是否更少;以及（1b）在整个21个月研究期间体重减轻是否比对照个体更多。次要目标将：（2a）检查生活方式和自我调节变化的条件差异（例如，饮食、活动、体重），心理结果（例如，抑郁症状）和体重稳定性;（2b）检查基线调节因子（例如，性别）;以及（2c）调查调解人（例如，剥夺，努力和注意力，以及自我效能）。

DESCRIPTION (provided by applicant): Despite the benefits of weight loss, attempts at weight-loss maintenance are short-lived. Once active maintenance interventions end, individuals often give up lifestyle and self-regulatory changes and regain the weight they lost. We propose that individuals need to learn a novel set of stability skills that optimize current satisfaction with lifestyle and self-regulatory habits: (a) learn to eat a healthy diet and be more active without feeling deprived (relative deprivation theory) and (b) learn to regulate or 'fine-tune' the balance between eating, activity, and weight with the minimum effort and attention necessary (limited resources theory). We also propose that individuals will be more successful if they learn these stability skills before initiating weight loss (i.e., stability first), thus, capitalizing on initial motivation, providing mastery, and increasing self-efficacy for maintaining a stable weight in the future (social cognitive theory). The current revision will test whether learning stability skills before losing weight improves long-term weight management (i.e., during a subsequent follow-up). In this randomized trial, 232 overweight and obese adults will be randomly assigned to 1 of 2 conditions. In the Stability Skills condition, individuals will initially learn stability skills in a 3-month preparatory module before participating in a standard 6-month behavioral weight-loss program. In the Control condition, individuals will initially learn nutrition consumer skills (of demonstrated interest to participants but unrelated to weight stability and maintenance) in a 3-month preparatory module before participating a standard weight-loss program identical to that received in Stability Skills. Participants in both conditions will be assessed during a 12-month follow-up after the weight-loss programs; offered the same number of classes during the 9-month intervention period; and will start and finish the 6-month weight loss programs at the same time. Outcomes will be measured at baseline, 3, 9, 15 and 21 months. Primary aims will examine whether Stability Skills individuals (1a) gain less weight during the 12-month follow-up; and (1b) lose more weight over the entire 21-month study than Control individuals. Secondary aims will: (2a) examine condition differences on lifestyle and self-regulatory changes (e.g., diet, activity, weighing), psychological outcomes (e.g., depressive symptoms), and weight stability; (2b) examine baseline moderators (e.g., gender); and (2c) investigate mediators (e.g., deprivation, effort and attention, and self-efficacy).