The objective of the proposed Mentored Research Scientist Career Development Award is to promote the candidate's development as an independent clinical trial researcher in mind-body medicine with a focus on the prevention and treatment of obesity and the metabolic syndrome. Obesity is the fastest growing epidemic with 65% of Americans overweight or obese. The vast majority who achieve short-term weight loss, gain it back over time. Psychological stress contributes to overeating, weight gain, and metabolic dysregulation. The stress-related motivation to consume calorically-dense palatable food has a physiological basis involving the hypothalamic-pituitary-adrenal axis and central opioidergic system. Standard weight loss programs fail to adequately address the impact of stress on food intake and metabolism. Dr. Daubenmier's research has shown that yoga and meditation practices are associated with greater psychological well-being, less disordered eating, greater weight loss, and improved metabolic function. These results indicate that mind-body interventions should be rigorously tested to determine whether they enhance the effectiveness of existing weight loss programs. The candidate seeks additional training in the design and conduct of randomized clinical trials (RCTs) of mind-body interventions and understanding of physiological mechanisms underlying stress-induced food intake and metabolic dysregulation. The University of California, San Francisco is an ideal environment for the proposed training because it provides access to experts in RCT methodology, mind-body interventions, and the basic sciences of physiological aspects of stress and relations to obesity and the metabolic syndrome. The training plan comprises formal coursework, informal tutorials with experts in their respective fields, and supervision of Dr. Daubenmier's leadership as PI on a RCT assessing the efficacy of a 3-month diet and exercise weight loss intervention incorporating mind-body techniques for overweight/obese women at risk for the metabolic syndrome. The control group intervention comprises diet and exercise guidelines only. Participants will be followed for one year to examine changes in weight, fat distribution, glucose tolerance, and potential psychological and physiological mediators. This research will help establish whether mind-body practices improve existing weight loss programs by normalizing healthy food intake, enhancing weight loss maintenance, and preventing metabolic sequelae.
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