Although surgery is the treatment of choice for severe obesity, very little is known about the relationship of lifestyle factors to patient outcomes after operation. This Mentored Patient-Oriented Research Career Development Award (K23) describes integrated training and research plans designed to prepare the candidate to pursue research on helping patients achieve optimal weight loss and lifestyle adjustment after bariatric surgery. A model of treatment is presented in which an intervention targeting behavioral (eating, activity, and compliance) and psychosocial factors (e.g., symptoms of binge eating and personality style) is expected to impact weight loss, health-related quality of life, and overall well-being. Advanced training in genetic and environmental influences on severe obesity, an expanded working knowledge of how surgeons treat severely obese patients, and consolidation of skills in longitudinal research methodology will assist in refining and developing this model. The research plan involves prospectively tracking weight-related variables, eating and activity, compliance and satisfaction, and psychosocial factors over time among a group severely obese patients undergoing surgery for weight loss (Study 1), and using the data to inform the development and evaluation of a lifestyle intervention geared to optimizing outcomes after operation (Study 2). The comprehensive lifestyle intervention will encompass 1) encouraging healthy eating habits, 2) increasing physical activity, 3) enhancing psychosocial adjustment. Adaptations to treatment will accommodate the unique needs of bariatric surgery patients. Specifically, a modular treatment format will address patients' changing needs in the preoperative, postoperative, and longer-term adjustment phases. Additionally, the intervention will be developed for delivery one-on-one at routine clinic visits with supplemental contact via the Internet. The data collected will contribute to the preparation of an R01 application that will involve conducting a full-scale randomized clinical trial to evaluate the modular, computer-aided lifestyle intervention. Future work may focus on adding adjunctive treatment components such as weight loss medication, the effects of which have not been adequately studied in bariatric surgery patients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DK062291-04
Application #
6917817
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
2002-08-01
Project End
2007-07-31
Budget Start
2005-08-01
Budget End
2006-07-31
Support Year
4
Fiscal Year
2005
Total Cost
$128,471
Indirect Cost
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
White, Marney A; Kalarchian, Melissa A; Levine, Michele D et al. (2015) Prognostic Significance of Depressive Symptoms on Weight Loss and Psychosocial Outcomes Following Gastric Bypass Surgery: A Prospective 24-Month Follow-Up Study. Obes Surg 25:1909-16
White, Marney A; Kalarchian, Melissa A; Masheb, Robin M et al. (2010) Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psychiatry 71:175-84
Kalarchian, Melissa A; Marcus, Marsha D; Levine, Michele D et al. (2008) Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis 4:544-9
Wildes, Jennifer E; Kalarchian, Melissa A; Marcus, Marsha D et al. (2008) Childhood maltreatment and psychiatric morbidity in bariatric surgery candidates. Obes Surg 18:306-13
Levine, Michele D; Kalarchian, Melissa A; Courcoulas, Anita P et al. (2007) History of smoking and postcessation weight gain among weight loss surgery candidates. Addict Behav 32:2365-71
Kalarchian, Melissa A; Marcus, Marsha D; Levine, Michele D et al. (2007) Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry 164:328-34;quiz 374
Kalarchian, Melissa A; Marcus, Marsha D; Levine, Michele D et al. (2005) Behavioral treatment of obesity in patients taking antipsychotic medications. J Clin Psychiatry 66:1058-63