Development of an integrative intervention to decrease overeating drive and improve weight loss maintenancee

NIH Pandemic-Era Grants

Pandemic Era Grants

2024

Document text

Principal Investigator: Rachel Miller Radin
Organization: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Fiscal Year: 2024
Award: $172,098
Funding agency: National Center for Complementary and Integrative Health

Project Summary/Abstract
A critical problem facing behavioral weight-loss interventions for adults with obesity is the tendency towards weight regain following weight loss. This is due in part to a failure to address the behavioral lynchpins that underlie obesity for a significant subset: overeating drive (e.g., eating for psychological relief, compulsive eating). This drive can independently lead to insulin resistance and metabolic syndrome, making it a crucial behavioral target. The objective of this K23 Mentored Patient-Oriented Research Career Development application is to provide me with high-level training to become an expert in targeting overeating drive, using mindfulness-based and motivational approaches to promote healthy eating. Mindful eating (ME) components may be an important addition to weight loss programs to more directly target overeating drive. Motivational interviewing (MI) is already established as an effective treatment component to help with weight loss and may help reduce overeating drive. No studies have examined MI in combination with ME, herein referred to as ‘Mindful Motivation’ (MM). Congruent with NCCIH’s initiative on advancing the science of symptom management through integrative health interventions, the proposed project aims to 1) identify and optimize specific targets of MM interventions that may reduce overeating drive and 2) pilot test the refined MM intervention in an RCT design with an active control condition (general digital mindfulness). To this end, I will examine pilot study data in which adults with overweight receive 8-weeks of MM. Based on these findings, along with data from focus groups and consultation with a team of experts, I will identify which aspects of the MM intervention most strengthened the target (overeating drive) and optimize these components. I will develop a light touch intervention utilizing both MI and ME components. I will examine which treatment components are most effective (in comparison to the active control) in targeting mechanisms of overeating drive (primarily self- efficacy, impulse control). Preliminary findings will inform an R-level application that evaluates the MM intervention in an adequately powered RCT. This research will help develop mindfulness-based treatments most suitable for adults with overweight and overeating drive, and may promote long-term metabolic health.
Building on my advanced training as a clinical health psychologist with expertise in eating behavior, the K23 mechanism addresses my critical training needs in mechanism-focused intervention development and evaluation. The training plan includes coursework, meetings, readings, and qualitative research to fill these gaps. I have assembled an outstanding team of mentors and advisors at UCSF (Drs. Epel, Mason, Adler, Hartogensis, Le Grange, and Garber) and outside of UCSF (Drs. Wolever, Cassin and West) with expertise in complementary areas. As my long-term career goal is to develop and disseminate integrative interventions to improve the health of individuals with obesity, the K23 mechanism will provide me with opportunities to grow as an independent clinical researcher, and develop better evidence-based strategies.

Terms: <21+ years old><Address><Adult><Adult Human><Area><Awareness><Behavioral><Binge Eating><Body Weight decreased><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Clinical><Collaborations><Communities><Consultations><Data><Development><Drops><Eating><Eating Behavior><Educational Achievement><Educational Status><Enrollment><Evaluation><Failure><Fellowship><Focus Groups><Food Intake><Goals><Health><Healthy Eating><Hunger><Hyperphagia><Individual><Insulin Resistance><Integrative Medicine><Integrative Therapy><Integrative Treatment><Integrative intervention><Intervention><Intervention Strategies><Investigators><K-Awards><K-Series Research Career Programs><K23 Award><K23 Mechanism><K23 Program><Knowledge><Lead><Light><Maintenance><Measures><Meditation><Mentored Patient-Oriented Research Career Development Award><Mentored Patient-Oriented Research Career Development Award (K23)><Mentors><Metabolic><Metabolic dysfunction><Metabolic syndrome><Mindfulness Approach><Mindfulness Therapy><Mindfulness Training><Mindfulness Treatment><Mindfulness-based Approach><Mindfulness-based Therapy><Mindfulness-based Training><Mindfulness-based Treatment><Motivation><NCCAM><NCCIH><National Center for Complementary and Integrative Health><National Center for Complementary and Integrative Medicine><Obesity><Over weight><Overeating><Overweight><Participant><Pattern><Pb element><Phase><Photoradiation><Pilot Projects><Postdoc><Postdoctoral Fellow><Psychologist><Public Health><Qualitative Research><Randomized><Randomized, Controlled Trials><Research><Research Associate><Research Career Program><Research Personnel><Researchers><Sampling><Science><Self Efficacy><Testing><Touch><Touch sensation><Training><United States><Weight><Weight Gain><Weight Increase><Weight Loss><Weight Reduction><Work><acceptability and feasibility><active control><adiposity><adult adiposity><adult obesity><adulthood><adults with obesity><behavior change><body weight gain><body weight increase><body weight loss><career><career development><compulsive eating><compulsive feeding><compulsive overeating><consultation><corpulence><craving><design><designing><develop therapy><developmental><diaries><digital><educational level><effective therapy><effective treatment><emotional eater><emotional eating><enroll><evidence base><heavy metal Pb><heavy metal lead><high risk><high risk group><high risk individual><high risk people><high risk population><improved><infancy><infantile><insulin resistant><insulin tolerance><integrative healing><integrative health><intervention design><intervention development><intervention refinement><interventional strategy><manage symptom><meeting><meetings><mindfulness><mindfulness intervention><mindfulness-based intervention><motivational enhancement therapy><motivational intervention><motivational interview><novel><patient oriented research><patient oriented study><pilot study><pilot test><polyphagia><post-doc><post-doctoral><post-doctoral trainee><programs><psychologic><psychological><randomisation><randomization><randomized control trial><randomly assigned><research associates><symptom management><symptom science><tactile sensation><therapy design><therapy development><training achievement><training level><training status><trait><treatment design><treatment development><treatment effect><weight loss intervention><weight loss program><weight loss programming><weight loss therapy><weight loss treatment><weights><wt gain><wt-loss>