A remote-based yoga intervention for improving long-term weight loss

项目总结 具有强大传播潜力的有效干预措施对于解决肥胖症流行病至关重要。 互联网提供的减肥(IDWL)计划克服了面对面减肥的许多常见障碍 干预措施(例如，地理限制、缺乏儿童保育、费用高)，但减肥大约是 其中一半是在面对面治疗中观察到的。改善长期减肥(WL)的新方法 在IDWL内部，需要程序。瑜伽已经被发现是一种治疗各种疾病的有效策略 健康状况(例如，心血管疾病风险因素、抑郁症、疼痛综合征)，但在很大程度上被内部忽视 肥胖管理的背景。瑜伽也被证明可以增强自我调节能力(例如， 情绪调节、认知调节和自我相关的过程)，这些都是防止WL发生的重要因素 长期的。尽管如此，到目前为止，只有两项随机试验结合了瑜伽和行为WL治疗。 虽然最初的发现是有希望的，但显著的限制包括缺乏对照组和小样本 一项研究中的大小，另一项研究中的短期随访(12周)。此外，瑜伽影响的机制 体重管理计划中的WL还没有被探索过。在我们的初步研究中，我们发现，提供 在三个月的行为WL治疗后，瑜伽对饮食失误(即离散的)产生了良好的效果 威胁WL的饮食不坚持事件)，改善情绪，增强抵抗饮食的能力 与接触相匹配的对照组相比，更具诱惑力。此外，瑜伽对WL和WL有显著影响 衡量失败者的自我调节能力(承受痛苦、正念和自我同情) 在治疗的前三个月内体重增加。坚持瑜伽干预、保持和 节目满意度很高。拟议的试验在这些有希望的初步发现的基础上进行了扩展 通过增加瑜伽治疗的时间(3至9个月)，对参与者进行为期18个月的评估 时期，扩大参与者特征(包括男性和增加种族/族裔多样性)，以及 增加样本大小，以便有足够的能力检查主要(WL)和次要结果 (饮食失误和其他可能引发饮食失误的不适经历)在12个月时。 此外，它试图通过正式评估以下机制来填补文献中的一个重要空白 瑜伽影响世界卫生组织。所有个人将获得为期12个月的互联网交付的WL计划，并将 在第3个月末随机参加9个月的瑜伽课程(通过视频会议提供)或9个月 健康和健康计划(接触者匹配对照)。参与者将被跟踪6个月，超过 治疗结束(18个月时进行最终评估)。这一完全远程的试验具有巨大的潜力，可以影响到 瑜伽和体重控制领域，特别是相关的新研究表明，许多 个人现在更喜欢在线医疗计划，而不是面对面的计划。

PROJECT SUMMARY Effective interventions with strong dissemination potential are critical for addressing the obesity epidemic. Internet-delivered weight loss (IDWL) programs overcome many of the barriers common to face-to-face interventions (e.g., geographical constraints, lack of childcare, high cost), but weight losses are approximately half of that observed within in-person treatment. Novel approaches for improving long-term weight loss (WL) within IDWL programs are needed. Yoga has been found to be an effective strategy for treating a variety of health conditions (e.g., CVD risk factors, depression, pain syndromes), but has been largely overlooked within the context of obesity management. Yoga has also been shown to strengthen self-regulatory skills (e.g., emotion regulation, cognitive regulation, and self-related processes) which are important for keeping WL off long-term. Nonetheless, only two randomized trials to date have combined yoga and behavioral WL treatment. While findings are initially promising, significant limitations include a lack of a control group and small sample size in one study and a short follow-up (12 weeks) in the other. Also, mechanisms through which yoga impacts WL within a weight management program have not been explored. In our pilot study, we found that providing yoga following three months of behavioral WL treatment led to favorable effects on dietary lapses (i.e., discrete episodes of dietary non-adherence which threaten WL), improved affect, and increased ability to resist dietary temptations compared to a contact-matched control. Further, yoga had a significant effect on WL and measures of self-regulation (distress tolerance, mindfulness, and self-compassion) among individuals who lost more weight within the first three months of treatment. Adherence to the yoga intervention, retention, and program satisfaction ratings were high. The proposed trial expands upon these promising preliminary findings by increasing the length of yoga treatment (3 to 9 months), assessing participants over a longer, 18-month period, broadening participant characteristics (including men and increasing racial/ethnic diversity), and increasing the sample size, so that it is sufficiently powered to examine primary (WL) and secondary outcomes (dietary lapses and other uncomfortable experiences which could trigger a dietary lapse) at 12 months. Further, it seeks to fill an important gap in the literature by formally assessing the mechanisms through which yoga impacts WL. All individuals will receive a 12-month Internet-delivered WL program and will be randomized at the end of month 3 to a 9-month yoga program (delivered via videoconference) or 9-month health and wellness program (contact-matched control). Participants will be followed for 6 months beyond the end of treatment (final assessment at 18 months). This fully remote trial has great potential to impact both the yoga and weight control fields and is particularly relevant given emerging research indicating that many individuals now prefer online healthcare programs vs. in-person programs.