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Pilot test of a novel food response and attention training treatment for obesity: Brain imaging data suggest actions shape valuation.

ABSTRACT: Elevated brain reward and attention region response, and weaker inhibitory region response to high-calorie food images have been found to predict future weight gain. These findings suggest that an intervention that reduces reward and attention region response and increases inhibitory control region response to such foods might reduce overeating. We conducted a randomized pilot experiment that tested the hypothesis that a multi-faceted food response and attention training with personalized high- and low-calorie food images would produce changes in behavioral and neural responses to food images and body fat compared to a control training with non-food images among community-recruited overweight/obese adults. Compared to changes observed in controls, completing the intervention was associated with significant reductions in reward and attention region response to high-calorie food images (Mean Cohen's d = 1.54), behavioral evidence of learning, reductions in palatability ratings and monetary valuation of high-calorie foods (p = 0.009, d's = 0.92), and greater body fat loss over a 4-week period (p = 0.009, d = 0.90), though body fat effects were not significant by 6-month follow-up. Results suggest that this multifaceted response and attention training intervention was associated with reduced reward and attention region responsivity to food cues, and a reduction in body fat. Because this implicit training treatment is both easy and inexpensive to deliver, and does not require top-down executive control that is necessary for negative energy balance obesity treatment, it may prove useful in treating obesity if future studies can determine how to create more enduring effects.

SUBMITTER: Stice E

PROVIDER: S-EPMC5656010 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Pilot test of a novel food response and attention training treatment for obesity: Brain imaging data suggest actions shape valuation.

Stice Eric E Yokum Sonja S Veling Harm H Kemps Eva E Lawrence Natalia S NS

Behaviour research and therapy 20170419

Elevated brain reward and attention region response, and weaker inhibitory region response to high-calorie food images have been found to predict future weight gain. These findings suggest that an intervention that reduces reward and attention region response and increases inhibitory control region response to such foods might reduce overeating. We conducted a randomized pilot experiment that tested the hypothesis that a multi-faceted food response and attention training with personalized high- ...[more]

PMID: 28505470

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Project description:ObjectivesEffective government policies are essential to increase the healthiness of food environments. The International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) has developed a monitoring tool (the Healthy Food Environment Policy Index (Food-EPI)) and process to rate government policies to create healthy food environments against international best practice. The aims of this study were to pilot test the Food-EPI, and revise the tool and process for international implementation.SettingNew Zealand.ParticipantsThirty-nine informed, independent public health experts and non-governmental organisation (NGO) representatives.Primary and secondary outcome measuresEvidence on the extent of government implementation of different policies on food environments and infrastructure support was collected in New Zealand and validated with government officials. Two whole-day workshops were convened of public health experts and NGO representatives who rated performance of their government for seven policy and seven infrastructure support domains against international best practice. In addition, the raters evaluated the level of difficulty of rating, and appropriateness and completeness of the evidence presented for each indicator.ResultsInter-rater reliability was 0.85 (95% CI 0.81 to 0.88; Gwet's AC2) using quadratic weights, and increased to 0.89 (95% CI 0.85 to 0.92) after deletion of the problematic indicators. Based on raters' assessments and comments, major changes to the Food-EPI tool include strengthening the leadership domain, removing the workforce development domain, a stronger focus on equity, and adding community-based programmes and government funding for research on obesity and diet-related NCD prevention, as good practice indicators.ConclusionsThe resulting tool and process will be promoted and offered to countries of varying size and income globally. International benchmarking of the extent of government policy implementation on food environments has the potential to catalyse greater government action to reduce obesity and NCDs, and increase civil society's capacity to advocate for healthy food environments.

Project description:BACKGROUND:Obesity is a highly prevalent condition with multiple adverse health consequences. Widely available first-line treatments for obesity, such as dietary and other lifestyle interventions, typically have only short-term effects. Thus, new treatment approaches are needed. Novel interventions such as Attention Bias Modification Training (ABMT) and mindfulness-based interventions focus on modifying different maladaptive cognitive patterns typically present in people with obesity (e.g. attention bias to food cues); however, their mechanisms of action remain largely unknown. We describe the theoretical basis and the rationale for a study protocol of a feasibility randomised controlled trial (RCT) comparing two attention trainings (ABMT vs Mindfulness Training [MT]) in people with overweight or obesity. The aim of this study is to inform the development of a large-scale RCT in relation to acceptability and attendance rates and to identify preliminary evidence for the interventions' clinical efficacy and potential underlying mechanisms. DESIGN:Forty-five adults who are either overweight or obese (minimum body mass index of 25 kg/m2) will be randomly allocated to receive eight sessions over eight weeks of either computerised ABMT or MT or be on a waiting list. Clinical and cognitive outcomes will be assessed at baseline, post-treatment (8 weeks) and follow-up (12 weeks post-randomisation). These include mood, body composition and attention biases. Credibility and acceptability of the trainings will be assessed using questionnaires, and recruitment and retention rates will be recorded. DISCUSSION:Findings will inform the feasibility of developing a large-scale RCT that takes into consideration effect sizes for primary outcome measures and the acceptability of the design. The study will also provide preliminary evidence on the clinical efficacy of two different attention trainings for people with obesity and associated underlying mechanisms. TRIAL REGISTRATION:ISRCTN Registry, ISRCTN15745838. Registered on 22 May 2018.

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Pilot test of a novel food response and attention training treatment for obesity: Brain imaging data suggest actions shape valuation.

Publications

Pilot test of a novel food response and attention training treatment for obesity: Brain imaging data suggest actions shape valuation.

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