Impulsive Behavior in Adolescent Health Weight and Obese Smokers and Nonsmokers

说明(申请人提供)：大约20%的肥胖青少年也吸烟，约占总人口的5%。单独来看，肥胖和吸烟都会使人们在许多健康问题上面临极大的风险。然而，肥胖和吸烟者的结合会极大地增加风险。体重指数大于或等于35并且吸烟的人的死亡风险是不吸烟的健康体重的6-11倍。此外，吸烟状况是成年人和青少年成功减肥的始终如一的障碍，肥胖吸烟者更有可能退出治疗，最不可能显著减肥。不幸的是，肥胖吸烟者在治疗和预防文献中是一个代表不足的群体，到目前为止，几乎没有研究确定增加肥胖吸烟者风险的行为因素。为了回应对确定这一高危人群行为特征的研究的需求，拟议研究的主要目标将是使用自我报告和实验室行为评估对冲动进行比较，将青少年肥胖吸烟者与肥胖非吸烟者、健康体重吸烟者和健康体重非吸烟者进行比较。纳入行为冲动评估将产生有关青少年肥胖吸烟者行为风格的高度具体信息。这些信息可能会导致治疗方案的修改，以改善那些在努力做出重大生活方式行为改变方面面临最大挑战的肥胖青少年的结果。这项拟议研究的第二个目标将是探索冲动与特定饮食行为模式之间的关系。最近的证据表明，冲动的人会吃得更冲动。然而，这些研究几乎完全使用了自我报告的冲动测量方法，没有一项研究调查了肥胖吸烟者和不吸烟者的饮食行为。这个额外目的的结果可能会通过允许探索不同体重和吸烟状况类别中的特定进食动机和行为来改进对我们主要问题的解释。

DESCRIPTION (provided by applicant): Approximately 20% of adolescents who are obese also smoke, which accounts for approximately 5 percent of the population. Independently, both obesity and cigarette smoking put people at great risk for a number of health conditions. However, the combination of being both obese and a smoker increase risk drastically. Individuals with a BMI greater than or equal to 35 and who also smoke have a mortality risk 6 - 11 times that of healthy weight never-smokers. Furthermore, smoking status is a consistent barrier to successful weight loss in both adults and adolescents, with obese smokers more likely to drop out of treatment and least likely to make significant weight losses. Unfortunately, obese smokers are an underrepresented group in the treatment and prevention literature, and little research to date has identified behavioral factors that increase the risk of becoming an obese smoker. In response to the need for research that identifies behavioral attributes of this at-risk group, the primary objective of the proposed research will be to compare a sample of adolescent obese smokers to obese non- smokers, healthy-weight smokers, and healthy-weight non-smokers using both self-report and laboratory- behavioral assessments of impulsivity. The inclusion of behavioral impulsivity assessments stands to yield highly specific information about the behavioral styles of adolescent obese smokers. Such information may lead to treatment-program modifications to improve outcomes for those obese adolescents most challenged in their efforts to make significant lifestyle behavior changes. A secondary objective of the proposed research will be to explore the relationship between impulsivity and particular patterns of eating behavior. Recent evidence indicates that more impulsive individuals engage in more impulsive eating. However, these studies almost exclusively used self-report measures of impulsivity and none had examined the eating behavior of obese smokers and non-smokers. Results from this additional aim may improve interpretation of our primary question, by allowing the exploration of specific eating motivations and behaviors both across and within the different weight- and smoking-status categories.