People with high food sensitivity lost more weight and, importantly, were more successful at keeping the pounds off using a new alternative weight loss intervention that aims to improve a person’s response to internal hunger cues and their ability to resist food, one team reported. led by experts at the University of California, San Diego (UCSD) in the May 18, 2022 online issue of Open JAMA Network.
“Some people are very sensitive to food cues. That is, they can’t resist food and/or can’t stop thinking about food. Behavioral weight loss skills don’t are not sufficient for these individuals, so we designed an alternative approach to address this clinical need,” said first author Kerri N. Boutelle, PhD, UC San Diego professor at the Herbert Wertheim School of Public Health and Human Longevity Science, and the Department of Pediatrics in the School of Medicine.
About 74% of adults in the United States are overweight or obese. Behavioral weight loss programs, which include calorie counting, have been the treatment of choice. However, not everyone responds and most people regain the lost weight.
For those who have trouble resisting food, weight loss can be especially difficult. This food reactivity is both inherited and shaped by the environment and individual factors.
In the PACIFIC (Providing Adult Collaborative Interventions for Ideal Changes) randomized clinical trial, researchers compared their intervention, called Signal Regulation, to a behavioral weight loss program, a control group and a cohort that combined signal regulation. cues with the behavioral program. .
Weight loss was comparable after 24 months in people participating in both the cue regulation program and the behavioral weight loss program.
However, participants in the Signal Regulation arm stabilized and maintained their weight while participants in the other groups regained weight mid-treatment when clinic visits were reduced to once a month.
“Our results suggest that appetitive mechanisms targeted by signal regulation may be particularly critical for weight loss in people who have difficulty resisting food and could be used in a personalized medicine approach,” Boutelle said.
According to the Centers of Disease Control and Prevention, overweight and obesity are risk factors for heart disease, stroke, type 2 diabetes and certain cancers, all of which are among the leading causes of preventable death. .
Over a 12-month period, 271 adults aged 18 to 65 received 26 group treatments. They were all asked to engage in at least 150 minutes of moderate- or vigorous-intensity physical activity per week.
The Signal Regulation intervention did not require participants to follow a diet. Instead, it entailed the use of natural cues indicating when to eat rather than focusing on calories, it built tolerance to food cravings and focused on inhibiting cravings for appetizing foods. when there is no physical hunger.
Palatable foods — usually foods that contain high amounts of sugar or fat with the addition of salt and flavorings — stimulate the reward system in the brain and can be especially hard to resist.
The control arm provided nutrition education, social support, and mindfulness training. The behavioral weight loss program prescribed a diet, limited high-calorie foods, reinforced avoidance of overeating cues, and focused on calorie restriction. The combined program integrated the food and energy intake focus of the behavioral weight loss program with cue regulation, including hunger cue management.
“People who need help losing weight can seek out the Signal Regulation Program if behavioral weight loss hasn’t worked for them, if they feel they have trouble resisting eating, or if they never feel full,” Boutelle said.
Signal regulation is proposed in another randomized clinical trial called Solutions for Hunger and Diet Regulation and at UC San Diego’s Center for Healthy Eating and Activity Research, of which Boutelle is the director. .
Reference: “Effect of a new intervention targeting appetite traits on body mass index in overweight or obese adults: a randomized clinical trial” May 18, 2022, Open JAMA Network.
Co-authors include: Dawn M. Eichen, David R. Strong, Dong-Jin Eastern Kang-Sim, and Cheryl L. Rock, all with UC San Diego; Carol B, Peterson, University of Minnesota; and Bess Marcus, Brown University.
This research was funded, in part, by the National Institutes of Health (R01DK103554, UL1TR001442).