Current behavioral obesity treatments (e.g., behavioral weight loss; BWL) are not effective for nearly 80% of people in the long term. Accordingly, there is a pressing need to develop novel treatments to target alternative mechanisms that might be interfering with the success of current treatments. Growing research has identified significant neurocognitive deficits, particularly in relation to executive function, among adults with overweight or obesity. Compensatory Cognitive Trainings have been used to improve executive function in various populations including schizophrenia and traumatic brain injury, as well as normal aging adults. In line with a recent NIH Working Group Report, that concluded there is a great need for a ?deeper understanding of cognitive function? in regards to its impact on weight loss and maintenance, this application seeks to develop a Novel Executive Function Treatment (NEXT) for obesity. NEXT will be adapted from previous compensatory cognitive trainings and will be iteratively pilot tested with 20 adults to refine the treatment based on initial qualitative feedback. Then, a preliminary randomized control trial will compare NEXT prior to BWL (NEXT+BWL) to a nutrition education comparison group prior to BWL (CON+BWL) to evaluate initial feasibility and acceptability of NEXT and NEXT+BWL. Lastly, NEXT+BWL will be compared to CON+BWL on weight loss, attendance and executive function outcomes at post-treatment and at a 6-month follow-up. The proposed research aims to advance the field?s understanding of current obesity treatment failure. The findings will be used as a basis for the applicant?s future R01 proposal. The proposed study fits well with the applicant?s career development goals. The candidate has a strong background in obesity and eating disorder research with prior clinical training in neuropsychology. The overarching goal of this 5-year training program is to evolve the candidate into an independent clinical scientist. The specific training goals include: 1) training in treatment development and alternative study design to evaluate new treatments; 2) advanced training in neuropsychology related to obesity and neuropsychological assessment, and; 3) training in advanced statistics, with a strong focus on how to manage and analyze data for longitudinal treatment trials. The mentorship team consists of internationally-recognized experts in obesity, compensatory cognitive treatment, and statistics who will oversee the execution of the training plan and foster career development. Research and training will occur at the University of California San Diego, which is a ripe environment for fostering junior investigators through a transition to independence. This award will provide the required time, funding, and training needed to broaden the candidate?s expertise in the obesity field while simultaneously allowing her to become an independent investigator. As such, this proposal represents a critical first step in developing novel behavioral interventions for obesity with a focus on neurocognitive deficits.
Currently, the best behavioral treatments for obesity only work for 50% of adults, and of those who initially succeed, most do not maintain their weight loss. One reason for this failure may be due to neurocognitive deficits found among individuals with obesity, particularly related to executive function, which make it difficult for these adults to adhere to treatment recommendations. The proposed study aims to develop a Novel Executive Function Treatment (NEXT), which when administered prior to the behavioral treatment, could help improve outcomes by addressing the neurocognitive deficits in adults with overweight or obesity.
