Promoting Healthy Weight with "Stability First"

描述（由申请人提供）：尽管减肥有好处，但维持减肥的努力是短暂的。一旦主动维持干预结束，个人通常会放弃生活方式和自我调节的改变，并重新获得他们失去的体重。我们建议，个体需要学习一套新的稳定技能，以优化当前对生活方式和自我调节习惯的满意度：(a)学会健康饮食，在不感到被剥夺的情况下更活跃（相对剥夺理论）；(b)学会以最小的努力和注意力调节或“微调”饮食、活动和体重之间的平衡（有限的资源理论）。我们还建议，如果个人在开始减肥之前学习这些稳定技能（即稳定第一），那么他们将更成功，因此，利用最初的动机，提供掌握，提高自我效能，以在未来保持稳定的体重（社会认知理论）。目前的修订将测试减肥前学习稳定技能是否能改善长期体重管理（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两种情况中的一种。在稳定技能条件下，个人将在参加标准的6个月行为减肥计划之前，先在3个月的准备模块中学习稳定技能。在控制条件下，个人将首先在3个月的准备模块中学习营养消费者技能（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。在减肥项目结束后的12个月随访期间，将对两种情况下的参与者进行评估；在9个月的干预期内提供相同数量的课程；同时开始和完成为期6个月的减肥计划。结果将在基线、3、9、15和21个月进行测量。主要目的是检查稳定性技能个体（1a）在12个月的随访期间是否体重增加较少；（1b）在整个21个月的研究中，比对照组的人减掉了更多的体重。次要目标将：（2a）检查生活方式和自我调节变化（如饮食、活动、体重）、心理结果（如抑郁症状）和体重稳定性方面的状况差异；（2b）检查基线调节因素（如性别）；（2c）调查中介因素（如剥夺、努力和注意、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).