Promotion and Prevention in the Treatment of Obesity

项目摘要/摘要 肥胖是当今最重要的公共卫生问题之一，是导致肥胖的许多主要原因 美国的发病率和死亡率。尽管如此，治疗仍然很困难，许多人不断地 努力减肥。因此，迫切需要改进治疗肥胖症的方法。一 体重控制如此困难的潜在原因是需要牺牲眼前的快乐来实现长期目标。 这需要对健康等未来结果给予重大重视。 这样做的一个策略是，专注于避免不健康选择的潜在好处。健康状况 消息传递研究表明，关注于促进健康选择的长期好处的消息可能 然而，从长远来看，要有效地鼓励人们开始健康的行为，或对健康行为持积极的态度 这些信息的影响还没有在肥胖的背景下进行研究。相比之下，行为经济学 展望理论的研究表明，专注于预防未来的负面后果可能更好，而且 与减肥的好处相比，体重增加的威胁是更强大的动机。虽然预防 策略已经成功地应用于戒烟和反吸烟运动中，但它们并没有 通常用于治疗肥胖症。在有希望的初步神经成像工作中，我们发现 当使用这种预防策略时，大脑中参与抑制控制的区域和减少渴望的区域。 R03的目标是测试干预是否建立在防止长期 体重增加的后果与以促进健康的长期利益为目标的干预 减肥有益于改变食物选择决策中对健康和口味的评价，令人鼓舞 坚持，减少对食物的渴望和消耗，并最终减轻体重，与标准相比 行为减肥计划(BWL)。总共90名超重/肥胖的男性和女性将被随机 被分配用于预防、促进或标准BWL。每次干预将有一次面对面的培训 参与者将学习分配给他们的计划的关键策略，其余12个每周 课程将通过互联网授课。基线和3个月(治疗后)评估将包括食物 选择决策任务在父母K01中具有特色，以衡量健康和味道、体重的评估 测量，以及食物渴望和消费的测量。解决可行性、坚持性和 将在互联网计划期间收集参与措施(即，查看经验教训、自我监控)，以及 对课程内容的记忆将在处理后进行评估。个人差异衡量标准也将 收集以提供可能影响每一支手臂成功的因素的初步数据。 该项目测试肥胖症临床治疗的创新方法，并将提供新的见解。 关于预防和促进减肥策略的潜在作用，进一步建立了Demos博士的 独立研究生涯。

Project Summary/Abstract Obesity is one of the most important public health issues today, contributing to many of the primary causes of morbidity and mortality in the United States. Still, treatment remains difficult and many people continually struggle to lose weight. Thus there is critical need for improvements in methods for treating obesity. One potential reason weight control is so difficult is the need to sacrifice immediate pleasures for long-term goals. This requires placing significant value on future outcomes, such as health. One strategy for doing so is to focus on the potential benefits of avoiding unhealthy choices. Health messaging studies suggest that messages focused on promoting long-term benefits of healthier choices may be effective in encouraging initiation of, or positive attitudes toward, healthy behaviors, however, longer-term effects of these messages have not been studied in the context of obesity. By contrast, behavioral economic work on Prospect Theory suggests focusing on preventing future negative consequences may be superior, and the threat of weight gain is a more powerful motivator than the benefit of weight loss. Although prevention strategies have been successfully employed in smoking cessation and anti-smoking campaigns, they are not typically used in obesity treatment. In promising preliminary neuroimaging work, we identified increases in brain regions involved in inhibitory control and decreases in cravings when using this PREVENT strategy. The goal of this R03 is to test whether an intervention built upon the goal to PREVENT long-term consequences of weight gain versus an intervention built upon the goal to PROMOTE long-term benefits of weight loss is beneficial in altering valuation of health and taste in food choice decision-making, encouraging adherence, reducing food cravings and consumption, and ultimate weight loss, as compared to a standard behavioral weight loss program (BWL). A total of 90 overweight/obese men and women will be randomly assigned to either PREVENT, PROMOTE, or standard BWL. Each intervention will have one in-person training session wherein participants will learn key strategies of their assigned program, and the remaining 12 weekly lessons will be delivered via internet. Baseline and 3-month (post-treatment) assessments will include the food choice decision-making task featured in the parent K01 to measure valuation of health and taste, weight measurement, and measurement of food cravings and consumption. To address feasibility, adherence and engagement measures (i.e., lessons viewed, self-monitoring) will be collected during the internet program, and memory for lesson content will be assessed post-treatment. Individual difference measures will also be collected to provide preliminary data on factors that may influence success in each arm. This project tests innovative approaches in the clinical treatment of obesity and will provide new insights into the potential role of prevention versus promotion strategies for weight loss, further establishing Dr. Demos' independent research career.