Prevention of Obesity at Universities:A Randomized Trial

描述（由申请人提供）：由于肥胖症正在达到流行病的比例，导致显著的发病率和死亡率，并且对治疗有抵抗力，因此针对这一公共卫生问题制定预防计划至关重要。不幸的是，大多数普遍的预防计划并没有降低未来体重增加的风险。因此，我们决定将目标锁定在一部分人上大学的女性节制饮食者身上，她们可能有独特的动机来对饮食和活动水平进行持久的改变，从而降低肥胖发生的风险。在拟议的大学体重控制方案中，向少女传授减少食物份量和能量密度的方法，以及增加身体活动以防止体重增加的方法。干预利用来自社会和临床心理学的说服原则（例如，战略自我介绍，动机访谈），以增加参与者将作出持久的行为改变的可能性。5节干预相对于现存的方案是简短的，这应该有利于传播。一项初步试验（N = 188）发现，完成该计划早期版本的参与者在2年的随访中肥胖发作的风险（3%）显著低于仅评估对照组（11%），并且在健康饮食和活动水平方面表现出更大的改善。该计划还减少了进食障碍症状和负面影响，这很重要，因为这些障碍的特点是功能障碍和不良后果。因此，我们建议在2所当地大学进行一项大规模的随机试验，以增强这一针对性肥胖预防计划的版本。我们将350名大一新生（17-19岁）的女性克制进食者随机分配到对照组或实验组，并跟踪她们2年。我们将测试CWCP相对于未治疗对照条件是否导致（1）降低体脂增加和肥胖发作的风险，（2）改善能量摄入和饮食营养成分，（3）增加体力活动，（4）减少进食障碍和抑郁症状，以及（5）降低几种医学风险因素的水平。

DESCRIPTION (provided by applicant): Because obesity is reaching epidemic proportions, results in marked morbidity and mortality, and is resistant to treatment, it is vital to develop prevention programs for this public health problem. Unfortunately, most universal prevention programs have not reduced the risk for future weight gain. Thus, we decided to target a subset of individuals-female restrained eaters entering college-who might be uniquely motivated to make lasting changes to their diet and activity level that would decrease their risk for obesity onset. In the proposed College Weight Control Program (CWCP), adolescent females are taught methods to reduce the portion size and energy density of their food choices and to increase their physical activity to prevent weight gain. The intervention utilizes persuasion principles from social and clinical psychology (e.g., strategic self-presentation, motivational interviewing) to increase the likelihood that participants will make lasting behavioral changes. The 5-session intervention is brief relative to extant programs, which should facilitate dissemination. A preliminary trial (N = 188) found that participants who completed an earlier version of this program were at significantly lower risk for obesity onset (3%) over a 2-year follow-up relative to assessment-only controls (11%) and showed greater improvements in healthy eating and activity level. This program also reduced eating disorder symptoms and negative affect, which is important because these disturbances are marked by functional impairment and adverse outcomes. Accordingly, we propose to conduct a large-scale randomized trial of an enhanced version of this targeted obesity prevention program at 2 local universities. We will randomly assign 350 female restrained eaters (aged 17-19) during their freshman year to the control or experimental group and follow them for 2 years. We will test whether the CWCP, relative to a no-treatment control condition, results in (1) decreased risk for gain of body fat and onset of obesity, (2) improvements in energy intake and the nutritional composition of the diet, (3) increases in physical activity, (4) decreased eating disorder and depressive symptoms, and (5) reduced levels of several medical risk factors.