Targeting Food Cue Reactivity and Satiety Sensitivity to Decrease Binge Eating and Weight
Abstract
This application addresses the Fiscal Year 2017 (FY17) Peer Reviewed Medical Research Program (PRMRP) Topic Area of eating disorders and the FY17 PRMRP Area of Encouragement for studies to identify the most effective treatments for patients with an eating disorder and a comorbid disorder. This proposal focuses on helping military Veterans who have Binge Eating Disorder (BED) and overweight or obesity. BED and obesity are extremely costly to the Department of Defense and Department of Veterans Affairs (VA) and result in increased medical costs as well as reduced ability to serve. Currently, the treatment with the majority of empirical support for BED is Cognitive Behavior Therapy (CBT). To date, CBT studies suggest that participants decrease their binge eating and many (40%-60%) become abstinent. However, there is very little weight loss, which theoretically should occur when binges decrease. We have developed a novel model of treatment, called Regulation of Cues (ROC), which focuses on increasing responsiveness to hunger and satiety cues and decreasing responsiveness to food cues in the environment. We have pilot tested the ROC components twice with children with overweight and obesity, and once with adults who binge eat with overweight and obesity. We also have preliminary data on the ROC model with adults with overweight and obesity from an ongoing randomized trial. Our preliminary data suggest that the ROC model is feasible and well-accepted by children, adults, and parents. Additionally, it shows initial efficacy in changing binge eating, eating behavior, cognitions, and weight loss. Our team, including the VA San Diego Healthcare System collaborators, is experienced in recruiting participants with BED and obesity, and with providing CBT-based treatments of Veterans with BED and obesity. This application, which is the next logical step in this program of research, will test the ROC model with Veterans with BED and overweight and obesity and compare it to the current gold-standard treatment, CBT. ROC is especially relevant to military Service members and Veterans as they may have learned to ignore their own physiology in the field and by learning to sense hunger and understanding physiological triggers to binge eating could provide skills that they may not have had access to in the past. The objective of this randomized controlled trial is to compare ROC to CBT and to evaluate the feasibility, acceptability, and efficacy in reducing binge eating and weight in Veterans. A total of 120 Veterans will be recruited primarily from VA San Diego Healthcare System and through community recruitment. We expect that ROC will be well-accepted and attended by participants, with equivalent or better rates of attendance and acceptability ratings equal to that of CBT. We hypothesize that participants in ROC will have a greater reduction in binge eating (as measured by the Eating Disorder Examination; Eating Disorder Examination-Questionnaire and Binge Eating Scale) at the mid-treatment, post-treatment, and 6-month follow-up compared to CBT. We hypothesize that participants in ROC will lose more weight and decrease their energy intake across all time points compared to CBT. A secondary aim is to determine the extent to which ROC and CBT influence underlying mechanisms of action, including responsivity to food cues, satiety responsiveness, and reward-based eating. As an exploratory aim, we will evaluate moderators of treatment (age, gender, binge eating status, satiety responsiveness, responsivity to food cues, reward-based eating), and mediators of treatment outcomes (responsivity to food cues, satiety responsiveness, reward-based eating, and physical activity). The proposed work has the potential to reduce BED and obesity in Veterans and individual Service members, reduce overall healthcare costs for the military and VA, and also could be applicable to both Veteran and active duty Service members. If shown to be effect
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810220
Entities
People
- Kerri Boutelle
Organizations
- United States Army
- University of California, San Diego