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增加，迫切需要针对年轻患者的有效减肥治疗。最近，减肥手术已被认为是一种治疗严重超重的青少年，因为在体重和身体健康的后续改善的显着下降的潜力。这个指导患者导向的职业发展奖（K23）的广泛目的是检查心理因素和严重超重的相互作用，以确定可观察到的心理症状（心理表型）的特定模式是否有助于预测减肥手术的结果。该项目代表了研究计划的关键第一步，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。该K23应用程序描述了一项培训和研究计划，使候选人成为一名独立的临床研究人员，拥有测量心理和身体健康之间随时间变化的关系以及开发和验证青少年饮食和体重障碍的新型治疗方法的专业知识。研究计划包括：（1）对参加减肥手术计划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）通过远程医疗提供的治疗干预的开发和试点测试。本申请的次要目的包括评价精神症状和治疗干预对术后随访和体重减轻依从性的影响。拟议的研究将要求候选人获得额外的培训，在治疗肥胖青少年，提供远程治疗（远程医疗），纵向和治疗结果的研究。拟议研究的数据将广泛适用于研究心理因素与慢性健康状况青年治疗依从性之间的相互作用。拟议的K23奖的结果还将用于开发R级赠款申请，以进行更大规模的试验，评估远程医疗治疗干预的疗效。 公共卫生相关性：儿童和青少年超重的流行是一个国家公共卫生危机。随着越来越多的青少年和他们的父母考虑减肥手术治疗严重肥胖，需要更多的研究来检查影响手术建议的依从性的因素以及严重超重青少年身心健康的相互作用。

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.