Facilitating Health Behavior Change among Morbidly Obese Adolescents

描述（由申请人提供）：随着美国儿童和青少年超重和肥胖率的上升，迫切需要对年轻患者进行有效的减肥治疗。最近，减肥手术被认为是治疗严重超重的青少年的一种方法，因为它有可能大幅减少体重并随后改善身体健康。这个指导病人导向的职业发展奖（K23）的主要目的是研究心理因素与严重超重的相互作用，以确定可观察到的心理症状的特定模式（心理表型）是否有助于预测减肥手术的结果。这个项目代表了一个研究项目的关键的第一步，以了解和解决寻求减肥手术的严重肥胖青少年的心理和身体健康之间的相互作用。这份K23申请描述了一个培训和研究计划，使候选人成为一名独立的临床研究人员，具有长期测量心理和身体健康之间关系的专业知识，并开发和验证针对青少年饮食和体重失调的新疗法。研究计划包括：(1)对参加减肥手术项目的严重肥胖青少年的精神病理学进行纵向前瞻性测量，以及(2)通过远程医疗提供治疗干预的开发和试点测试。本应用程序的次要目的包括评估精神症状的影响和治疗干预对术后随访预约和体重减轻的依从性。拟议的研究将要求候选人在治疗肥胖青少年、提供远程治疗（远程医疗）以及纵向和治疗结果研究方面获得额外的培训。拟议研究的数据将广泛适用于研究心理因素与青年慢性健康状况依从性之间的相互作用。拟议的K23奖助金的结果还将用于开发r级拨款申请，以进行更大规模的试验，评估远程医疗治疗干预的有效性。

DESCRIPTION (provided by applicant): With increasing rates of overweight and obesity among children and adolescents in the United States, there is an urgent need for effective weight loss treatments for younger patients. Recently, bariatric surgery has been considered as a treatment for seriously overweight adolescents because of the potential for substantial decreases in weight and subsequent improvements in physical health. The broad aim of this Mentored Patient- Oriented Career Development Award (K23) is to examine the interaction of psychological factors and serious overweight to determine if particular patterns of observable psychological symptoms (psychological phenotypes) are helpful in predicting outcomes of bariatric surgery. This project represents a crucial first step in a program of research to understand and address the interaction between mental and physical health among severely obese adolescents seeking bariatric surgery. This K23 application describes a plan of training and research for the candidate to become an independent clinical researcher with expertise in measuring relationships between mental and physical health over time and developing and validating novel treatments for eating and weight disorders in adolescence. The research plan involves: (1) the longitudinal prospective measurement of psychopathology among severely obese adolescents enrolled in a bariatric surgery program, and (2) the development and pilot testing of a treatment intervention delivered via telemedicine. Secondary aims of this application include evaluating the effect of psychiatric symptoms and the treatment intervention on compliance with post-surgery follow-up appointments and weight loss. The proposed research will require the candidate to obtain additional training in the treatment of obese adolescents, the provision of remote treatment (telemedicine), and longitudinal and treatment outcome research. Data from the proposed study will be broadly applicable to the study of interactions between psychological factors and compliance with treatment for youth with chronic health conditions. The results of the proposed K23 award will also be used in the development of a R-level grant application to conduct a larger trial evaluating the efficacy of the telemedicine treatment intervention. PUBLIC HEALTH RELEVANCE: The prevalence of overweight among children and adolescents is a national public health crisis. As more adolescents and their parents consider bariatric surgery for the treatment of severe obesity, additional research is needed to examine factors influencing compliance with surgical recommendations and the interaction of physical and mental health among seriously overweight adolescents.