Behavioral weight loss programs in their many forms can be an effective means to tackle or prevent obesity, but not everyone is suited to lifestyle interventions that involve calorie counting and increased physical activity. The authors of a new study have drawn up an alternative approach that retrains the minds of people highly responsive to food cues to resist cravings, and demonstrated that it may outperform current go-to strategies for long-term weight loss.
Devised by scientists at the University of California San Diego, the experimental weight loss intervention explored in this study is designed for people who experience powerful internal hunger cues and find it hard to resist food. Known as behavioral susceptibility theory, this is based on the notion that genetically inherited appetitive traits and the current food environment combine to put certain individuals at a higher risk of obesity.
“There are individuals who are very food cue responsive," said first author Kerri N. Boutelle. "That is, they cannot resist food and/or cannot stop thinking about food. Behavioral weight loss skills are not sufficient for these individuals, so we designed an alternative approach to address this clinical need."
Boutelle and her colleagues used behavioral susceptibility theory as the basis for a novel approach to weight loss. The team calls its intervention "Regulation of Cues," and it uses psychoeducation to teach subjects about situations, thoughts, moods and environments that lead to overeating, and experiential learning to develop psychological coping skills to decrease sensitivity to food cues and tolerate cravings.
This involved having patients monitor their hunger before and after meals, or how those hunger levels changed depending on their mood, for example. The program also exposed subjects to highly craved foods when they were already full as a form of cue-exposure treatment, for example, and using coping skills to resist cravings and monitoring the effects.
The 271 overweight adults that took part in the study underwent 26 group treatments over a 12-month period, and were tasked with completing at least 150 minutes of moderate or vigorous intensity exercise each week. The subjects were then randomly assigned either a Regulation of Cues lifestyle intervention, a behavioral weight loss program with a strict diet and calorie limits, a combination of these two, or placed in a control group that received nutrition education, social support and mindfulness training.
Observations 24 months later found that weight loss was comparable between the Regulation of Cues participants and the behavioral weight loss participants. But the scientists found that the latter group more readily regained weight thereafter, while the Regulation of Cues participants were able to stabilize their body weight and keep the pounds off.
“Our findings suggest that the appetitive mechanisms targeted by Regulation of Cues may be especially critical for weight loss among individuals who have trouble resisting food and could be used in a personalized medicine approach,” said Boutelle.
While only a pilot study, the scientists say the results indicate the Regulation of Cues intervention could be a feasible approach to weight loss for adults prone to binge eating. For those struggling to control their body weight through other interventions, the technique could therefore provide an effective alternative.
“Individuals who need help losing weight can seek out the Regulation of Cues program if behavioral weight loss did not work for them, if they feel they have trouble resisting eating, or if they never feel full,” said Boutelle.
The research was published in the journal JAMA Network Open.