Computerized Response Training Obesity Treatment
| Status: | Recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - 38 |
| Updated: | 1/6/2019 |
| Start Date: | July 15, 2017 |
| End Date: | March 31, 2022 |
| Contact: | Sonja Yokum, PhD |
| Email: | sonjas@ori.org |
| Phone: | (541) 484-2123 |
Translational Neuroscience: Response Training for Obesity Treatment
This project will test whether a food response training intervention produces lasting body
fat loss, use objective brain imaging to examine the mechanism of effect of this treatment
and investigate the generalizability of the training to non-training foods, and examine
factors that should amplify intervention effects to provide a test of the intervention
theory. This novel treatment represents a bottom-up implicit training intervention that does
not rely on executive control, prolonged caloric deprivation, and expensive clinicians to
deliver, like behavioral weight loss treatments that have not produced lasting weight loss.
If this computer-based response training intervention produces sustained body fat loss in
overweight individuals, it could be easily implemented very broadly at almost no expense,
addressing a leading public health problem.
fat loss, use objective brain imaging to examine the mechanism of effect of this treatment
and investigate the generalizability of the training to non-training foods, and examine
factors that should amplify intervention effects to provide a test of the intervention
theory. This novel treatment represents a bottom-up implicit training intervention that does
not rely on executive control, prolonged caloric deprivation, and expensive clinicians to
deliver, like behavioral weight loss treatments that have not produced lasting weight loss.
If this computer-based response training intervention produces sustained body fat loss in
overweight individuals, it could be easily implemented very broadly at almost no expense,
addressing a leading public health problem.
Obesity causes 300,000 US deaths yearly, but most treatments do not result in lasting weight
loss. People who show greater brain reward and attention region response, and less inhibitory
region response, to high-calorie food images/cues show elevated future weight gain,
consistent with the theory that overeating results from a strong approach response to
high-calorie food cues paired with a weak inhibitory response. This implies that an
intervention that reduces reward and attention region response to such food and increases
inhibitory control region response should reduce overeating that is rooted in exposure to
pervasive food cues. Computer-based response-inhibition training with high-calorie foods has
decreased attentional bias for and intake of the training food, increased inhibitory control,
and produced weight loss in overweight participants in 3 proof-of-concept trials, with
effects persisting through 6-mo follow-up. A pilot trial found that overweight/obese adults
who completed a multi-faceted 4-hr response-inhibition training with high-calorie food images
and response-facilitation training with low-calorie food images showed reduced fMRI-assessed
reward and attention region response to high-calorie training foods and greater body fat loss
than controls who completed a rigorous 4-hr generic response-inhibition/response-facilitation
training with non-food images (d=.95), producing a 7% reduction in excess body fat over the
4-wk period. The investigators propose to evaluate a refined and extended version of this
response-training intervention.
Aim 1: Randomize 180 overweight/obese adults to a 4-wk response training obesity treatment or
a generic inhibition training control condition that both include bi-monthly
Internet-delivered booster training for a year and a smart phone response training app that
can be used when tempted by high-calorie foods, assessing outcomes at pre, post, and at 3-,
6-, and 12-month follow-ups (e.g., % body fat, the primary outcome).
Aim 2: Use fMRI to test whether reduced reward and attention region response, and increased
inhibitory region response to high-calorie food images used and not used in the response
training mediate the effects of the intervention on fat loss. The investigators will also
test whether during training participants show acute reductions in reward and attention
region response, and increases in inhibitory response to high-calorie training food images to
capture the learning process, assess generalizability of the intervention to food images not
used in training, and collect behavioral data on mediators.
Aim 3: Test whether intervention effects will be stronger for those who show less inhibitory
control in response to high-calorie food images, a genetic propensity for greater dopamine
signaling in reward circuitry, and greater pretest reward and attention region response, and
weaker inhibitory region response to high-calorie food images, based on the theory that
response training is more efficacious for those with a strong pre-potent approach tendency to
high-calorie foods.
loss. People who show greater brain reward and attention region response, and less inhibitory
region response, to high-calorie food images/cues show elevated future weight gain,
consistent with the theory that overeating results from a strong approach response to
high-calorie food cues paired with a weak inhibitory response. This implies that an
intervention that reduces reward and attention region response to such food and increases
inhibitory control region response should reduce overeating that is rooted in exposure to
pervasive food cues. Computer-based response-inhibition training with high-calorie foods has
decreased attentional bias for and intake of the training food, increased inhibitory control,
and produced weight loss in overweight participants in 3 proof-of-concept trials, with
effects persisting through 6-mo follow-up. A pilot trial found that overweight/obese adults
who completed a multi-faceted 4-hr response-inhibition training with high-calorie food images
and response-facilitation training with low-calorie food images showed reduced fMRI-assessed
reward and attention region response to high-calorie training foods and greater body fat loss
than controls who completed a rigorous 4-hr generic response-inhibition/response-facilitation
training with non-food images (d=.95), producing a 7% reduction in excess body fat over the
4-wk period. The investigators propose to evaluate a refined and extended version of this
response-training intervention.
Aim 1: Randomize 180 overweight/obese adults to a 4-wk response training obesity treatment or
a generic inhibition training control condition that both include bi-monthly
Internet-delivered booster training for a year and a smart phone response training app that
can be used when tempted by high-calorie foods, assessing outcomes at pre, post, and at 3-,
6-, and 12-month follow-ups (e.g., % body fat, the primary outcome).
Aim 2: Use fMRI to test whether reduced reward and attention region response, and increased
inhibitory region response to high-calorie food images used and not used in the response
training mediate the effects of the intervention on fat loss. The investigators will also
test whether during training participants show acute reductions in reward and attention
region response, and increases in inhibitory response to high-calorie training food images to
capture the learning process, assess generalizability of the intervention to food images not
used in training, and collect behavioral data on mediators.
Aim 3: Test whether intervention effects will be stronger for those who show less inhibitory
control in response to high-calorie food images, a genetic propensity for greater dopamine
signaling in reward circuitry, and greater pretest reward and attention region response, and
weaker inhibitory region response to high-calorie food images, based on the theory that
response training is more efficacious for those with a strong pre-potent approach tendency to
high-calorie foods.
Inclusion Criteria:
- Body Mass Index Between 25 and 35
Exclusion Criteria:
We found this trial at
1
site
Eugene, Oregon 97403
Principal Investigator: Eric Stice, PhD
Phone: 541-484-2123
Click here to add this to my saved trials
