Study protocol of a randomised controlled feasibility study of food-related computerised attention training versus mindfulness training and waiting-list control for adults with overweight or obesity

Abstract

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/m 2) 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.

Does concurrent self-administered transcranial direct current stimulation and attention bias modification training improve symptoms of binge eating disorder? Protocol for the TANDEM feasibility randomized controlled trial

“…In fact, in a letter to Brain Stimulation, Caulfield and George (2020) called for this type of approach, saying that the time is ripe for investigating at home neurotherapeutics, and that tDCS is a prime candidate ( 64 ). Third, we have tested our CBM intervention (ABMT) in trials involving adults with obesity ( 54 ) and anorexia nervosa: in this latter case, training focused on altering avoidance of food, as opposed to bias toward high-calorie foods ( 65 ). As such, we have a useful preliminary understanding of the therapeutic effects of ABMT in populations with EDs and disordered eating behaviors, and a good understanding of how participants view the treatment (i.e., acceptable, accessible, and credible).…”

“…Attention bias toward high calorie foods will be assessed using the visual probe task described in Mercado et al ( 54 ). In TANDEM, as participants will be taking part from home, webcam based eye-tracking technology (as opposed to specialist lab-based eye-tracking equipment) will be used to record eye movements.…”

“…Food-related attention will be assessed using the food-specific attention network task described in Heve, Stingl et al ( 55 ) and in Mercado et al ( 54 ). This task examines three components of attention (alerting, orienting, and executive function) using food (low- and high-calorie) and non-food picture stimuli.…”

Mindfulness como terapêutica nos distúrbios alimentares: uma revisão integrativa de literatura / Mindfulness as therapeutic in eating disorders: an integrative literature review

“…Brazilian Journal of Health Review, Curitiba, v.4, n.2, p. 9076-9093 mar./apr. 2021 comportamentos impulsivos que podem levar a excessos e, consequentemente, ao ganho de peso(MERCADO et al, 2020).O sofrimento psicológico em obesos está intimamente ligado às frustradas tentativas de perda de peso. Dessa forma, a atenção plena atua na aceitação, sensibilização…”

A inter-relação entre preocupações e sintomas depressivos em adultos com ansiedade generalizada: uma análise cross-lagged

“…Dentre as opções controle historicamente utilizadas, por exemplo, a lista de espera é uma das mais criticadas, já que a manutenção dos participantes na análise a despeito de qualquer intervenção oferecida poderia superestimar os efeitos dos tratamentos testados (Cunningham, Kypri & McCambridge, 2013). Contudo, apesar das críticas, a comunidade científica continua publicando estudos utilizando esse tipo de controle (e.g., Mercado, Werthmann, Campbell & Schmidt, 2020). Seguindo um princípio ético institucional diferente, no ECR a partir do qual este estudo foi elaborado utilizou-se outro tipo de intervenção psicoterapêutica, a Terapia de Apoio Não-Diretiva (TAND) (Markovitz, 2014).…”