New weight loss intervention targets appetitive traits

In a new study, researchers designed and tested a weight loss treatment based on genetically determined appetitive traits that influence patients’ desire to eat.

The study was published in JAMA Network and led by Kerri Boutelle, PhD, University of California San Diego professor in the Herbert Wertheim School of Public Health and Human Longevity Science and in the School of Medicine Department of Pediatrics. The study set out to evaluate the effectiveness of a weight loss program combining behavioral weight loss strategies with regulation of hunger cues.

“There are individuals who are very food cue responsive. That is, they cannot resist food and/or cannot stop thinking about food,” said Boutelle in a statement. “Behavioral weight loss skills are not sufficient for these individuals, so we designed an alternative approach to address this clinical need.”

Researchers conducted a randomized clinical trial in a university clinic with a total of 271 participants aged 18 to 65 with a body mass index (BMI) of 25 to 45 and a lack of comorbidities. From Dec. 2015 to Dec. 2019 participants attended 26 group treatments and engaged in 150 minutes of moderate to vigorous exercise each week.

Participants were split into three groups. The first group was not assigned a diet, rather they were trained to use natural hunger cues, reducing urges to eat hard-to-resist foods containing high amounts of sugar, salt, or fat when they were not experiencing hunger. In this group, appetitive traits such as food responsiveness (FR) and satiety responsiveness (SR) were targeted. The second group were provided with nutrition education, mindfulness training, and social support. The third group used a behavioral weight loss program which prescribed a restricted caloric intake diet and trained participants to use avoidance cues when temped to overeat.

The study’s results showed that the intervention of integrative behavioral weight loss strategies with regulation of cues significantly decreased patients’ BMI after the treatment. Those who were assigned the behavioral weight loss program had similar results to the integrated program. However, participants who received social support and underwent only mindfulness and nutrition training had significantly higher BMIs by the end of the trial period compared to the other groups. In addition, researchers found that patients who had higher levels of food responsiveness were more likely to lose weight using regulation of cues.

“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.