Targeting Emotional Eating and Weight Loss in Adolescents

摘要 在12-19岁的青少年中，大约有20%的人肥胖。青少年超重和肥胖是 与许多健康和心理社会后果有关，这些后果可以延续到成年。 从发育上看，青春期是一个生理和生理上以及情感上都发生重大变化的时期 发展。情绪调节在管理与他人的互动中至关重要，因此反映了一种重要的 青少年的任务。缺乏适应性情绪调节技能的青少年可能会转向饮食来调节 情绪，并提供短暂的负面情绪的缓解。情绪化进食实际上与 抑郁、暴饮暴食和肥胖。青少年肥胖症的行为减肥治疗现状 不处理情绪，在高消耗的情况下产生可变的减肥效果。合并为 针对情绪调节的治疗可能提供减少情绪化进食和 鼓励更大程度的减肥。辩证行为疗法(DBT)是一种循证治疗， 目标是情绪调节。我们创造了一种新的治疗模式，防止情绪化进食 (同龄人)通过将DBT技能与BWL相结合来调节情绪和减肥，以及 以情感为中心的家长培训计划。我们的试验数据表明，PEER是一种很有前途的治疗方法 超重和肥胖的青少年及其父母。这项拟议研究的目的是进一步评估 超重和肥胖青少年及其父母的同龄人计划。我们将招募和随机选择 160名青少年和他们的父母在两个地点进行同伴或标准的BWL-加州大学旧金山分校 迭戈和明尼苏达大学。治疗将以小组形式进行，疗程为6个月。 评估将在基线、治疗中期、治疗后、6个月随访和12个月进行 后续行动。主要目的包括评估Peer与BWL在青少年减肥方面的效果 (目标1)、情绪调节和情绪化进食(目标2)。次要目标包括检查差异 同伴与BWL在父母BMI、父母情绪调节、父母情绪化进食、父母情绪- 孩子之间的关系。最后，我们将探索青少年减肥的主持人和调解人，以及 情绪表型。这一应用是开发青少年治疗方法的关键下一步 以情绪调节和情绪化进食为作用机制的肥胖。

ABSTRACT Approximately 20% of adolescents aged 12-19 are obese. Overweight and obesity in adolescents are associated with numerous health and psychosocial consequences that can carry forward into adulthood. Developmentally, adolescence is a period of significant biological and physical changes, as well as emotional development. Emotion regulation is critical in managing interactions with others, and thus reflects an important task for adolescents. Adolescents who lack adaptive emotion regulation skills may turn to eating to regulate emotions and provide momentary relief of negative affect. Emotional eating is in fact associated with depression, binge eating and obesity. Current behavioral weight loss (BWL) treatment for adolescent obesity does not address emotions and produces variable weight-loss results with high attrition. Incorporating a treatment that targets emotion regulation may provide the skills needed to reduce emotional eating and encourage greater weight loss. Dialectical Behavior Therapy (DBT) is an evidence-based treatment that targets emotion regulation. We have created a new treatment model, Preventing Emotional Eating Routines (PEER) that targets both emotion regulation and weight loss by incorporating DBT skills with BWL, as well as an emotion-focused parent training program. Our pilot data suggests that PEER is a promising treatment for overweight and obese adolescents and their parents. The objective of this proposed study is to further evaluate the PEER program with overweight and obese adolescents and their parents. We will recruit and randomize 160 adolescents and their parents to either PEER or standard BWL at two sites – University of California, San Diego and University of Minnesota. Treatment will take place in groups over the course of 6 months. Assessments will be conducted at baseline, mid-treatment, post-treatment, 6-month follow-up, and 12-month follow-up. Primary Aims include to evaluate the efficacy of PEER compared to BWL on adolescent weight loss (Aim 1), emotion regulation and emotional eating (Aim 2). Secondary Aims include examining differences between PEER and BWL on parent BMI, parent emotion regulation, parent emotional eating, and the parent- child relationship. Lastly, we will explore moderators and mediators of adolescent weight loss, as well as emotion phenotypes. This application is a critical next step in the development of a treatment for adolescent obesity targeting emotion regulation and emotional eating as a mechanism of action.