An innovative, physical activity-focused approach to weight loss maintenance

一种以身体活动为重点的创新维持减肥方法

• 批准号: 8919355
• 负责人: Meghan Butryn
• 金额: $ 56.83万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8919355
• 关键词: Address; Adherence; Adult; Aftercare; Behavior Therapy; Behavioral; Body Weight decreased; Communities; Decision Making; Diet; Eating Behavior; Educational process of instructing; Effectiveness; Energy Metabolism; Epidemic; Exercise; Health; Health Benefit; Impaired health; Individual; Intervention; Link; Maintenance; Mediating; Mediator of activation protein; Motivation; Obesity; Obesity associated disease; Outcome; Participant; Phase; Physical activity; Prevention; Quality of life; Recruitment Activity; Research; Testing; Time; Weight; Weight maintenance regimen; Work; base; behavior change; clinically significant; design; disorder risk; distress tolerance; disturbance in affect; follow-up; group intervention; improved; innovation; intervention effect; novel; programs; psychologic; skills; theories

DESCRIPTION (provided by applicant): Obesity is causally linked with numerous health problems. State-of-the-art behavioral interventions for obesity reliably facilitate clinically significant weight loss in the short-term, but weight regain (and a return to elevated disease risk is normative. Innovative interventions that improve long-term outcomes of lifestyle modification must be developed and tested. New evidence suggests that a high level of physical activity (PA) is a critical component of weight loss maintenance (and has numerous ancillary health benefits, independent of weight). Most adults who are prescribed high levels of PA (whether as part of a weight management program or other intervention) do not ultimately adhere to these prescriptions, suggesting that traditional behavioral skills and intervention strategies are not sufficiently matched to the challenges of this critical, long-term behavior change. Theoretical and empirical work strongly suggest that for obese adults to be successful at consistently engaging in high levels of PA they must employ specific psychological skills, including mindful decision-making, behavioral commitment in the face of challenges, an ability to tolerate physical and psychological discomfort, and an ability to achieve clarity about one's personal values. These skills are the focus of acceptance-based behavioral interventions for PA promotion. To test the effectiveness of this approach, this study will recruit 300 adults from the community and provide them with 6 months of group-based standard behavioral weight loss treatment (Phase I). In Phase II, participants will receive one of three interventions, to be delivered for an additional 12 months: 1) behavioral treatment, with the standard emphasis on maintaining changes in diet and PA (BT), 2) behavioral treatment, with a primary emphasis on using these skills to maintain PA (BT-PA), or 3) acceptance-based behavioral treatment, with a primary emphasis on using these skills to maintain PA (ABT- PA). The PA prescription will be uniform across conditions. All participants will be encouraged to gradually progress to and subsequently maintain an amount of PA that will result in 2000 kcal/wk of energy expenditure. Assessments will be conducted at baseline, 6 months (end of Phase I treatment), 18 months (end of Phase II treatment), 24 months (6-month follow-up), and 36 months (18-month follow-up). An intensive focus on PA after initial weight loss (i.e., BT-PA and ABT-PA) is hypothesized to result in a) better weight loss maintenance, and b) higher amounts of PA at post-treatment and follow-up compared to standard behavioral treatment (BT). An intensive focus on PA after initial weight loss is also hypothesized to result in a) better weight loss maintenance and b) higher amounts of PA at post-treatment and follow-up when acceptance-based behavioral skills are taught (i.e., ABT-PA), compared to when standard behavioral skills are taught (BT-PA). Theory- driven mediators and moderators of intervention effects also will be examined. Accomplishing these aims will advance research on health-related behavior change and has the potential to meaningfully impact the behavioral prevention and treatment of many obesity-related diseases and conditions.

描述（由申请人提供）：肥胖与许多健康问题有因果关系。肥胖症的最新行为干预措施可靠地促进了短期的临床重量体重减轻，但是体重恢复（恢复到疾病升高的风险是规范性的。必须开发和验证长期生活方式的创新干预措施。新的证据表明，大多数人体重维持体重的较高的体重（PA）是多大的体重，并且是许多人的体重维护（PA）。规定的PA的高水平（无论是体重管理计划的一部分还是其他干预措施）最终都不遵守这些处方，这表明传统的行为技巧和干预策略与这种关键的，长期的行为变化的挑战不足以匹配，使他们在理论上有强烈的态度，使肥胖者在高层中的态度进行培养。挑战，能够忍受身体和心理不适的能力以及能够明确个人价值观的能力。这些技能是基于接受的行为干预PA促进的重点。为了测试这种方法的有效性，这项研究将招募社区的300名成年人，并为他们提供6个月的基于组的标准行为减肥治疗（I期）。在第二阶段中，参与者将接受三种干预措施之一，再提供12个月：1）行为治疗，标准的重点是保持饮食和PA（BT）的变化（2），2）行为治疗，主要强调使用这些技能来维持PA（BT-PA），或3）基于接受的行为治疗，并主要强调这些技能，以维持这些技能来维持PA（Abt pa）（Abt pa）。 PA处方在条件下将是统一的。将鼓励所有参与者逐步发展并随后保持一定数量的PA，这将导致2000 kcal/wk的能量支出。评估将在基线，6个月（I期治疗结束），18个月（II期治疗结束），24个月（6个月的随访）和36个月（18个月的随访）进行评估。假设初次体重减轻后，对PA的密集关注（即，BT-PA和ABT-PA）被认为可以导致a）更好的减肥维持，b）与标准行为治疗（BT）相比，治疗后和随访时的PA量更高。还假设对PA的密集重点也被假设导致a）更好的减肥和b）在教授基于接受的行为技能时（即ABT-PA），与标准行为技能相比，治疗后和随访时的PA量更高（即ABT-PA）。理论驱动的介体和干预效果的主持人也将进行检查。实现这些目标将进一步研究与健康相关的行为改变的研究，并有可能影响许多与肥胖相关疾病和状况的行为预防和治疗。