Facilitating Health Behavior Change among Morbidly Obese Adolescents

描述(申请人提供)：随着美国儿童和青少年超重和肥胖率的增加，迫切需要为年轻患者提供有效的减肥治疗。最近，减肥手术被认为是治疗严重超重青少年的一种方法，因为它有可能大幅减轻体重，随后改善身体健康。这项以患者为导向的指导职业发展奖(K23)的广泛目标是研究心理因素和严重超重之间的相互作用，以确定特定的可观察到的心理症状(心理表型)模式是否有助于预测减肥手术的结果。该项目是了解和解决寻求减肥手术的严重肥胖青少年心理和身体健康之间相互作用的研究计划中至关重要的第一步。这份K23应用程序描述了一项培训和研究计划，以使候选人成为一名独立的临床研究人员，具有测量随着时间的推移心理和身体健康之间的关系以及开发和验证青春期饮食和体重障碍的新疗法的专业知识。这项研究计划包括：(1)对参加减肥手术计划的严重肥胖青少年进行精神病理学的纵向前瞻性测量，以及(2)通过远程医疗提供的治疗干预的开发和试点测试。这项应用的次要目标包括评估精神症状的影响和治疗干预对术后随访预约的依从性和减肥的影响。拟议的研究将要求候选人在肥胖青少年的治疗、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培训。这项拟议研究的数据将广泛适用于心理因素与慢性疾病青年治疗依从性之间相互作用的研究。拟议的K23奖的结果还将用于开发R级赠款申请，以进行一项更大规模的试验，评估远程医疗治疗干预的效果。 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及其父母考虑接受减肥手术治疗严重肥胖，需要进行更多的研究，以检查影响严重超重青少年遵守手术建议的因素以及身体和心理健康的相互作用。

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.