Rationale and design of the Response to Behavioral Obesity Treatment (REBOOT) study

Area of Science:

• Obesity Research
• Behavioral Science
• Health Disparities

Background:

• Individuals of lower socioeconomic status (SES) achieve significantly less weight loss in behavioral interventions compared to higher SES individuals.
• Potential factors contributing to this disparity include environmental limitations, decision-making patterns, and stress exposure.
• The Response to Behavioral Obesity Treatment (REBOOT) study seeks to uncover the mechanisms behind SES-related differences in weight loss outcomes.

Purpose of the Study:

• To identify the mechanisms driving socioeconomic disparities in behavioral weight loss outcomes.
• To investigate the role of daily adverse experiences, decision-making tendencies, and cognitive function in weight management.
• To understand how these factors influence adherence to weight control behaviors.

Main Methods:

• A six-month weight loss intervention comparing equal numbers of lower and higher SES adults with obesity.
• Primary outcomes include weight change; secondary outcomes include dietary lapses, self-monitoring adherence, and physical activity.
• Ecological momentary assessments (EMA) measured cognitive functions (working memory, decision-making, processing speed) and exposure to daily stressors.

Main Results:

• Analysis will examine if socioeconomic disparities in weight change are explained by differential exposure to adverse daily experiences and decision-making tendencies.
• The study will assess the joint impact of these factors on adherence to weight control behaviors.
• Neighborhood data on food environment, walkability, and safety were also collected.

Conclusions:

• Confirming study hypotheses will advance the understanding of disparities in obesity treatment.
• Findings may necessitate interventions to mitigate the negative effects of daily experiences on cognitive processes crucial for weight management.
• This research highlights the need for tailored approaches to address SES-related barriers in obesity treatment.