My long-term career goal is to be an independent investigator with a multidisciplinary program of research in the treatment of obesity. As a clinical psychologist, my prior training has focused on identifying and reducing harmful psychosocial consequences of obesity, including weight-based stigma. However, in order to achieve my goal of conducting research to reduce adverse health consequences and improve quality of life for persons with obesity, it is essential that I have additional training in the clinical treatment of obesity. The K23 award would enable me to devote 90% of my effort to filling critical gaps in my training and to conducting research that will facilitate my becoming an independent clinical investigator in obesity. The proposed training plan will support my career goals by addressing three fundamental areas: 1) conducting clinical trials in obesity treatment; 2) assessing and promoting study participants' engagement in physical activity; and 3) understanding biological mechanisms that increase risk for cardiometabolic disease. I will obtain training in these areas by: receiving guidance from expert mentors in the field; completing coursework and attending seminars; and engaging in related research activities. This training plan will give me the knowledge and skills needed to prepare a successful R01 application by the end of the K23 award period. My research project will complement my training objectives while also building upon my prior stigma- related research efforts. In a randomized controlled trial, I will test the effects on long-term weight loss of a novel clinical intervention designed to help individuals with obesity cope with weight stigma, combined with . standard behavioral weight loss. I believe that reducing WBI will improve long-term weight loss by increasing physical activity, a behavior consistently associated with greater long-term weight loss. This research project will also incorporate assessments of cardiometabolic risk to determine whether reducing WBI helps to improve physical health. The proposed research project could have significant clinical implications for enhancing the treatment of obesity and reducing the negative effects of weight stigma. The environment at the Center for Weight and Eating Disorders at the University of Pennsylvania (Penn) is ideal for supporting my training and research needs. The Center will provide practical resources for data management and participant recruitment, assessment, and treatment. I will receive mentorship primarily from Dr. Thomas Wadden, the Center's director. Additional mentorship and research resources will be provided by Dr. John Jakicic (director of the Physical Activity and Weight Management Center at the University of Pittsburgh School of Education) and Dr. Daniel Rader (director of the Penn Preventive Cardiovascular Program). Outside of these specific centers, I will have access to several other academic programs at Penn to support my training needs, including the Institute for Diabetes, Metabolism, and Obesity. Penn provides a remarkably rich environment that will enable me to achieve my research and training goals.

Public Health Relevance

Current behavioral treatments for obesity are effective in producing short-term, but not long-term weight loss, thus limiting their effectiveness in reducing long-term risk for cardiometabolic disease. Weight-based stigma may contribute to weight gain and poor physical health in persons with obesity. The proposed study seeks to improve long-term weight loss, as well as cardiometabolic and psychosocial health, by combining a behavioral weight loss intervention with a novel cognitive-behavioral intervention designed to alleviate weight-based stigma and its ill effects on health-promoting behaviors (e.g., physical activity).

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Mentored Patient-Oriented Research Career Development Award (K23)
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NHLBI Mentored Patient-Oriented Research Review Committee (MPOR)
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Nicastro, Holly L
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University of Pennsylvania
Schools of Medicine
United States
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Pearl, Rebecca L; Wadden, Thomas A; Allison, Kelly C et al. (2018) Causal Attributions for Obesity Among Patients Seeking Surgical Versus Behavioral/Pharmacological Weight Loss Treatment. Obes Surg 28:3724-3728
Tronieri, Jena Shaw; Wadden, Thomas A; Alfaris, Nasreen et al. (2018) ""Last Supper"" Predicts Greater Weight Loss Early in Obesity Treatment, but Not Enough to Offset Initial Gains. Front Psychol 9:1335
Pearl, R L; Puhl, R M (2018) Weight bias internalization and health: a systematic review. Obes Rev 19:1141-1163
Pearl, Rebecca L; Wadden, Thomas A (2018) Weight Stigma Affects Men Too. Obesity (Silver Spring) 26:949
Pearl, Rebecca L; Wadden, Thomas A; Tronieri, Jena Shaw et al. (2018) Short- and Long-Term Changes in Health-Related Quality of Life with Weight Loss: Results from a Randomized Controlled Trial. Obesity (Silver Spring) 26:985-991