Addressing Weight Bias Internalization to Improve Adolescent Weight Management Outcomes

解决体重偏差内在化问题，改善青少年体重管理成果

• 批准号: 10642307
• 负责人: Katherine Elizabeth Darling
• 金额: $ 18.82万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642307
• 关键词: Address; Adolescence; Adolescent; Adolescent obesity; Adult; Aftercare; Age; Anxiety; Attitude; Award; Behavior Control; Behavior Therapy; Behavioral Weight Control; Biological Markers; Body Weight decreased; Body mass index; C-reactive protein; Calories; Child; Clinical; Clinical Trials; Combined Modality Therapy; Consumption; Data; Dedications; Development; Diabetes Mellitus; Eating Behavior; Eating Disorders; Effectiveness; Environment; Exposure to; Fatty acid glycerol esters; Feedback; Focus Groups; Goals; Health; Heterogeneity; Hospitals; Hydrocortisone; Hypothalamic structure; Inflammation; Interleukin-6; Intervention; Intervention Trial; K-Series Research Career Programs; Knowledge; Maps; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Modeling; Obesity; Outcome; Overweight; Pathway interactions; Periodicity; Phase; Phase Ia Trial; Physiological; Pituitary Gland; Prevalence; Psychological Stress; Published Comment; Qualifying; Randomized; Randomized, Controlled Trials; Research; Research Personnel; Research Project Grants; Risk; Self Direction; Self-Examination; Stress; Structure; Testing; Training; Training Programs; Universities; Weight; Weight Gain; Weight maintenance regimen; Youth; acceptability and feasibility; adolescent health; adolescent health outcomes; behavior test; cohort; coping; critical developmental period; critical period; design; emotional eating; evidence base; experience; feasibility testing; improved; intervention effect; intervention refinement; loss of control over eating; novel; obesity treatment; physical conditioning; pilot test; pilot trial; psychological stressor; psychosocial stressors; research study; response; skills; social stigma; standard care; stressor; systemic inflammatory response; therapy development; verbal

PROJECT SUMMARY/ABSTRACT Weight bias internalization (WBI), or self-directed weight-based stigma, has been associated with a number of negative physical and mental health consequences for adolescents with obesity, including negative weight- related outcomes (e.g., increased calorie consumption, poorer weight loss outcomes). The prevalence and salience of WBI as a stressor impacting weight-related outcomes in adolescents paired with the heterogeneous response to interventions for adolescents with obesity highlights the potential utility of combined intervention for WBI and obesity in youth to promote improved weight management outcomes during this critical developmental period. This K23 award is designed to fill gaps in my training and support a research study that will provide next steps in improving the health of adolescents with obesity. The first phase of the research project will employ focus groups and an open pilot trial to develop and test feasibility of an integrated intervention that combines treatment for WBI with an evidence-based adolescent behavioral weight control (BWC). I will then conduct a small RCT to test the effects of the newly designed WBI+BWC intervention on WBI and mechanisms of weight- stigma stress induced weight gain, specifically physiological markers of stress (diurnal cortisol) and inflammation (c-reactive protein, interleukin-6), and dysregulated eating behaviors (emotional eating, loss of control, unhealthy weight control behaviors). I hypothesize that BWC combined with intervention for WBI, will lead to improvements in mechanisms of weight-stigma stress induced weight gain, in turn promoting improved weight loss outcomes. This research project has significant clinical implications for the improvement of adolescent BWC and reduction of the negative effects of weight-based stigma in adolescents. To conduct this research and fill critical gaps in my training that will facilitate becoming an independent investigator focused on behavioral treatment of obesity in adolescents, I will complete a rigorous, targeted training program. The proposed training plan includes developing expertise in 1) conducting RCTs to develop and test BWC interventions for adolescents; 2) theoretical and conceptual models of weight-based stigma and WBI; 3) integration of mechanisms in clinical trials focused on biological markers and dysregulated eating behaviors; and 4) professional development. This training will be conducted under the primary mentorship of Dr. Elissa Jelalian, with co-mentors Drs. Rebecca Puhl, Stephanie Parade, Andrea Goldschmidt, and contributor Dr. David Barker. The skills I will acquire map directly onto the proposed research project and provide the knowledge and expertise necessary to prepare a successful R01 application by the end of the award period. The mentorship team, in combination with the rigorous academic and training environment provided by the Weight Control and Diabetes Research Center at The Miriam Hospital and Brown University, represent an ideal environment to accomplish these training and research goals. Through this Career Development Award, I will establish myself as an independent investigator dedicated to the development of novel interventions to improve health outcomes for adolescents with obesity.

项目摘要/摘要 重量偏置内在化（WBI）或基于重量的污名与多个 对肥胖症的青少年产生负面影响，包括负重 - 相关结果（例如，卡路里消耗量增加，减肥结果较差）。流行和 WBI作为压力源的显着性影响了青少年与异质的压力相关结果 肥胖青少年对干预措施的反应强调了合并干预的潜在效用 WBI和青年肥胖症在这种关键发展期间促进体重管理的改善 时期。该K23奖旨在填补我的培训中的空白，并支持一项研究研究，该研究将提供下一步 改善肥胖青少年健康的步骤。研究项目的第一阶段将采用 焦点小组和开放试验试验，以开发和测试结合综合干预的可行性 WBI的处理基于证据的青少年行为体重控制（BWC）。然后我将进行 小型RCT测试新设计的WBI+BWC干预对WBI的影响和重量机制 柱头应力引起的体重增加，特别是胁迫的生理标记（日质皮质醇）和炎症 （C反应蛋白，白介素6）和失调的饮食行为（情绪饮食，失去控制，不健康） 体重控制行为）。我假设BWC与WBI的干预相结合，将导致改进 在体重污名应力的机制中，诱导体重增加，进而促进体重减轻的结果。 该研究项目对改善青少年BWC和减少具有重要的临床意义。 基于体重的污名对青少年的负面影响。进行这项研究并填补关​​键空白 我的培训将有助于成为专注于肥胖行为治疗的独立研究者 在青少年中，我将完成一个严格的，有针对性的培训计划。拟议的培训计划包括 在1）开发专业知识以开发和测试青少年的BWC干预措施； 2）理论 以及基于体重的污名和WBI的概念模型； 3）集成在临床试验中的机制集成 关于生物标记和失调的饮食行为； 4）专业发展。这个培训将是 在Elissa Jelalian博士的主要指导下，由Co-Mentors Drs进行。丽贝卡·普尔（Rebecca Puhl），斯蒂芬妮（Stephanie） 游行，安德里亚·戈德施密特（Andrea Goldschmidt）和撰稿人戴维·巴克（David Barker）博士。我将直接获得地图的技能 拟议的研究项目，并提供准备成功R01所需的知识和专业知识 在奖励期结束时申请。指导团队与严格的学术和 Miriam医院的体重控制和糖尿病研究中心提供的培训环境和 布朗大学是实现这些培训和研究目标的理想环境。通过这个 职业发展奖，我将成为专门致力于开发的独立调查员 新的干预措施以改善肥胖症青少年的健康状况。