Targeting food cue responsiveness for weight loss

摘要 每三个成年人中就有两个超重或肥胖，这与重大的医疗和健康问题有关。 心理后果。迄今为止，最成功的减肥治疗是行为减肥 (BWL)，包括营养和体育活动教育，以及行为治疗技术。 虽然有些成年人在这些项目中减肥，但三分之一到一半的人甚至没有反应。 随着时间的推移保持减肥率。这些低成功率表明， 机制，如食欲性状，可能会干扰对BWL的反应，并强调关键的 需要开发针对性的肥胖治疗模型。我们的数据表明，高食物反应性 (FR)是BWL失败的风险因素。我们开发了一种新的治疗肥胖的模型， 行为易感性理论，称为线索调节（ROC），其重点是降低FR， 改善饱腹感反应性（SR）。在这项研究中，我们建议招募超重和肥胖的成年人， 也表现出高水平的FR，以测试增强的ROC治疗方案（ROC+）对此的疗效。 特定行为表型。我们提出了一个3组随机对照试验，将比较ROC+，BWL 和有源比较器（AC）。我们将招募300名超重和肥胖的成年人， 在基线、治疗期间、治疗后以及6个月和12个月随访时对其进行评估。小学和 次要目标如下。主要目的1：比较ROC+与AC在体重指数（BMI）方面的差异。 疗程及随访。主要目的2：比较ROC+与BWL在体重指数（BMI）方面的差异。 疗程及随访。次要目的1：比较BWL与AC在2009年至2010年期间的体重指数（BMI）。 疗程及随访。次要目的2：比较ROC+、BWL和AC对饱腹感的敏感性， 治疗过程中对食物线索的敏感性、抑制、限制、热量摄入和暴饮暴食 和后续行动。探索性目的1：评价介质（FR、SR、限制、暴饮暴食）的影响， 随时间推移对体重减轻的治疗效应的调节因子（人口统计学、基线BMI）。该方案 研究是开发治疗成人特定表型的重要下一步， 超重/肥胖，并可能改变这些人的肥胖治疗模式。本研究将 有助于肥胖的食欲表型的研究，将为患有肥胖症的个体提供有针对性的治疗。 高FR，可以为肥胖成人的临床决策提供信息。

ABSTRACT Two out of every three adults has overweight or obesity, which is associated with significant medical and psychological consequences. To date, the most successful weight loss treatment is behavioral weight loss (BWL), which includes nutrition and physical activity education, as well as behavior therapy techniques. Although some adults lose weight in these programs, one third to one half do not respond with even bleaker rates of weight loss maintenance over time. These low success rates suggest that there are underlying mechanisms, such as appetitive traits, that may interfere with response to BWL and underscore the critical need to develop targeted models for the treatment of obesity. Our data suggest that high food responsiveness (FR) is a risk factor for failure in BWL. We have developed a new model for the treatment of obesity based on the Behavioral Susceptibility Theory, called Regulation of Cues (ROC), that focuses on decreasing FR and improving satiety responsiveness (SR). In this study, we propose to recruit adults with overweight and obesity who also exhibit high levels of FR to test the efficacy of an enhanced ROC treatment program (ROC+) for this specific behavioral phenotype. We propose a 3 arm randomized controlled trial that will compare ROC+, BWL and an active comparator (AC). We will recruit and randomize 300 adults with overweight and obesity and will assess them at baseline, during treatment, post-treatment, and at 6- and 12-month follow-up. Primary and secondary aims are as follows. Primary Aim 1: Compare ROC+ to AC on body mass index (BMI) over the course of treatment and follow-up. Primary Aim 2: Compare ROC+ to BWL on body mass index (BMI) over the course of treatment and follow-up. Secondary Aim 1: Compare BWL to AC on body mass index (BMI) over the course of treatment and follow-up. Secondary Aim 2: Compare ROC+, BWL and AC on sensitivity to satiety, sensitivity to food cues, inhibition, restriction, caloric intake, and overeating over the course of the treatment and follow-up. Exploratory aim 1: Evaluate effects of mediators (FR, SR, restriction, overeating) and moderators (demographics, baseline BMI) of treatment effects on weight loss over time. This program of research is an important next step in the development of treatments for specific phenotypes of adults with overweight/obesity, and could change the paradigm of obesity treatment for these individuals. This study will contribute to the study of appetitive phenotypes of obesity, will provide a targeted treatment for individuals with high FR, and could inform clinical decision making for adults with obesity.