ClinicalTrials.gg
CompletedNCT03375853CCUpdated Sep 26, 2023

Computerized Response Training Obesity Treatment

An interventional study of Computer Based Response Training Weight Loss Intervention and Generic Response Training Control Intervention in Obesity, Hyperphagia and Feeding and Eating Disorders, sponsored by Oregon Research Institute. Completed at 1 site in United States. Open to participants aged 18 Years to 38 Years. Per ClinicalTrials.gov, last updated 2023-09-26.

Sponsored by Oregon Research Institute · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
179
Allocation
Randomized
Ages
18 Years to 38 Years
Sex
All
01

Study summary

This project will test whether a food response training intervention produces lasting body fat loss, use objective brain imaging to examine the mechanism of effect of this treatment and investigate the generalizability of the training to non-training foods, and examine factors that should amplify intervention effects to provide a test of the intervention theory. This novel treatment represents a bottom-up implicit training intervention that does not rely on executive control, prolonged caloric deprivation, and expensive clinicians to deliver, like behavioral weight loss treatments that have not produced lasting weight loss. If this computer-based response training intervention produces sustained body fat loss in overweight individuals, it could be easily implemented very broadly at almost no expense, addressing a leading public health problem.

Read the detailed description

Obesity causes 300,000 US deaths yearly, but most treatments do not result in lasting weight loss. People who show greater brain reward and attention region response, and less inhibitory region response, to high-calorie food images/cues show elevated future weight gain, consistent with the theory that overeating results from a strong approach response to high-calorie food cues paired with a weak inhibitory response. This implies that an intervention that reduces reward and attention region response to such food and increases inhibitory control region response should reduce overeating that is rooted in exposure to pervasive food cues. Computer-based response-inhibition training with high-calorie foods has decreased attentional bias for and intake of the training food, increased inhibitory control, and produced weight loss in overweight participants in 3 proof-of-concept trials, with effects persisting through 6-mo follow-up. A pilot trial found that overweight/obese adults who completed a multi-faceted 4-hr response-inhibition training with high-calorie food images and response-facilitation training with low-calorie food images showed reduced fMRI-assessed reward and attention region response to high-calorie training foods and greater body fat loss than controls who completed a rigorous 4-hr generic response-inhibition/response-facilitation training with non-food images (d=.95), producing a 7% reduction in excess body fat over the 4-wk period. The investigators propose to evaluate a refined and extended version of this response-training intervention.

Aim 1: Randomize 180 overweight/obese adults to a 4-wk response training obesity treatment or a generic inhibition training control condition that both include bi-monthly Internet-delivered booster training for a year and a smart phone response training app that can be used when tempted by high-calorie foods, assessing outcomes at pre, post, and at 3-, 6-, and 12-month follow-ups (e.g., % body fat, the primary outcome).

Aim 2: Use fMRI to test whether reduced reward and attention region response, and increased inhibitory region response to high-calorie food images used and not used in the response training mediate the effects of the intervention on fat loss. The investigators will also test whether during training participants show acute reductions in reward and attention region response, and increases in inhibitory response to high-calorie training food images to capture the learning process, assess generalizability of the intervention to food images not used in training, and collect behavioral data on mediators.

Aim 3: Test whether intervention effects will be stronger for those who show less inhibitory control in response to high-calorie food images, a genetic propensity for greater dopamine signaling in reward circuitry, and greater pretest reward and attention region response, and weaker inhibitory region response to high-calorie food images, based on the theory that response training is more efficacious for those with a strong pre-potent approach tendency to high-calorie foods.

During the Covid-19 shelter-at-home order, we will not measure in person only outcomes including BodPod assessments, height and weight measurement for BMI calculation, electrocardiogram (ECG) assessments and fMRI scanning for all participants that have assessments due during this order.

02

Conditions studied

  • Obesity
  • Hyperphagia
  • Feeding and Eating Disorders

Keywords

  • Obesity
  • Dissonance
  • Response Training
  • Eating Disorder
  • Computer-based Training
03

In context

Obesity

11,522 studies on the registry are indexed under Obesity; 2,033 are open to participants now.

This study's enrollment of 179 is above the median of 67 across 9,006 interventional studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

Oregon Research Institute is the lead sponsor of 70 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 38 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Between 25 and 35

Exclusion criteria

Exclusion Criteria:

Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
179 participants (actual)

Study arms

  • Active comparator
    Control Condition

    Participants will complete computer based response training tasks that will incorporate pictures of birds, flowers, and mammals. As part of the computer based training, participants will be instructed to respond or inhibit response to certain of these stimuli in order to bring about a change in the participant response to certain stimuli. These tasks will be structured identically to those presented in the experimental condition, only the appearance and context of the stimuli will be different (i.e., non-food versus food items). The computer tasks described above comprise the Generic Response Training Control Intervention.

    Behavioral: Generic Response Training Control Intervention

  • Experimental
    Experimental Condition

    Participants will complete computer-based response training tasks that will incorporate pictures of healthy food, unhealthy food, and glasses of water. As part of the computer-based training, participants will be instructed to respond or inhibit responses to certain of these stimuli in order to bring about a change in the participant response to certain stimuli. These tasks will be structured identically to those presented in the control condition, only the appearance and context of the stimuli will be different (i.e., food versus non-food items). The computer tasks described above comprise the Computer Based Response Training Weight Loss Intervention. To optimize the intervention, we narrowed the low-calorie food stimulus set to make a better distinction between high-calorie and low-calorie foods and we changed the filler images (water and furry mammals) in the go/no-go task from 100% "go" to 50% "go" and 50% "no-go" to measure learning of stimulus-specific respond associations.

    Behavioral: Computer Based Response Training Weight Loss Intervention

Interventions

  • BehavioralComputer Based Response Training Weight Loss Intervention

    Participants complete four computer based training tasks each visit, over the course of a few lab visits. Participants then perform weekly booster sessions in a more natural home or community environment over the internet using the same computer based training tasks.

  • BehavioralGeneric Response Training Control Intervention

    Participants complete four computer based training tasks each visit, over the course of a few lab visits. Participants then perform weekly booster sessions in a more natural home or community environment over the internet using the same computer based training tasks.

06

What researchers measure

Primary outcomes

  1. Body Fat Change

    Change in participant's body fat percentage

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

Secondary outcomes

  1. Change in Eating Disorder Symptoms

    Eating disorder symptoms as measured with the Eating Disorder Diagnostic Interview

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  2. Dietary Restraint, Emotional Eating, and External Eating

    Change in Dietary Restraint, Emotional Eating, and External Eating (aggregate score) as measured by the Dutch Eating Behavior Questionnaire

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  3. Change in Disinhibited Eating Behavior

    Chang in Disinhibited Eating as measured by the Three Factor Eating Questionnaire

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  4. Change in Eating in the Absence of Hunger Behavior

    Change in Eating When Not Hungry as measured by the Eating in the Absence of Hunger Questionnaire

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  5. Change in Food Addiction Behavior

    Change in Problematic eating patterns associated with symptoms of addictive behaviors as measured by the Yale Food Addiction Scale

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  6. Change in Physical Activity

    Change in Physical Activity as measured by the Paffenberger Questionnaire

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  7. Change in Alcohol Use Behavior

    Change in Substance use frequency (i.e., number of times per day) for alcohol of participants as measured by the Daily Drinking Questionnaire

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  8. Change in Substance Use Behavior

    Change in Substance use frequency (i.e., number of times per day) for common recreational drugs of participants as measured by the Daily Drug Taking Questionnaire

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  9. Change in Participant Ratings of Unhealthy Food Palatability

    Change in Participant behavioral response to food pictures, and subjective palatability rating

    Time frame: Baseline, 1 month

  10. Change in Participant Ratings of Food Monetary Value

    Change in Participant behavioral response to food pictures, and willingness to pay given dollar amounts (aggregate score) for the pictured food

    Time frame: Baseline, 1 month

  11. Change in Food Craving and Liking Behavior

    Change Participant food craving behaviors as measured by the Food Craving and Liking Scale

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  12. Change in Body Mass Index

    Change in Participant BMI using standard methods of calculation

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  13. Change in mean R-Peak Amplitude

    Change in mean R-Peak Amplitude measured using three-lead ECG using PowerLab 8 Diagnostic Suite

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

  14. Change in Heart Rate Variability

    Change in Heart Rate Variability measured using three-lead ECG using PowerLab 8 Diagnostic Suite

    Time frame: Baseline, 1 month, 3 months, 6 months, 12 months

07

Study locations

1 site
  • Oregon Research Institute
    Eugene, Oregon 97403, United States
08

References and documents

Publications

  • Yokum S, Bohon C, Berkman E, Stice E. Test-retest reliability of functional MRI food receipt, anticipated receipt, and picture tasks. Am J Clin Nutr. 2021 Aug 2;114(2):764-779. doi: 10.1093/ajcn/nqab096. PubMed 33851199 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jul 2017 to primary completion in Aug 2023, 73 months.

Of 3,680 non-industry interventional studies with no phase under Obesity, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 43. This study's 73 months is above that.

Counting every sponsor, half of 3,843 studies reached it within 22 months; a quarter within 10 and three quarters within 42.

How these figures are worked out, and which studies are left out of them.

Registered
May 17, 2017
First posted
Dec 18, 2017
StartActual
Jul 15, 2017
Primary completionActual
Aug 31, 2023
CompletionActual
Sep 15, 2023
Last update
Sep 26, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 26, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03375853
Lead sponsor
Oregon Research Institute
Collaborators
Flinders University, University of Exeter, Radboud University Medical Center, University of Oregon
Responsible party
Sponsor
First posted
Dec 18, 2017
Start date
Jul 15, 2017
Primary completion
Aug 31, 2023
Completion
Sep 15, 2023
Last update
Sep 26, 2023

Study contacts

Eric Stice, PhD
principal investigator · Stanford University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2023. You cannot join it, but the record below documents what was studied.

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