title: Enhancing inhibitory learning to reduce overeating: Design and rationale of a cue exposure therapy trial in overweight and obese women.
abstract: The prevalence of overweight and obesity has increased substantially over the last decades. Weight loss attempts in overweight individuals are common, though they seldom result in successful long-term weight loss. One very promising treatment is food cue exposure therapy, during which overweight individuals are repeatedly exposed to food-associated cues (e.g., the sight, smell and taste of high-calorie foods, overeating environments) without eating in order to extinguish cue-elicited appetitive responses to food cues. However, only few studies have tested the effectiveness of cue exposure, especially with regards to weight loss. For exposure treatment of anxiety disorders, it has been proposed that inhibitory learning is critical for exposure to be effective. In this RCT, we translated techniques proposed by Craske et al. (2014) to the appetitive domain and developed a novel cue exposure therapy for overeating aimed at maximizing inhibitory learning. The current RCT tested the effectiveness of this 8-session cue exposure intervention relative to a control intervention in 45 overweight adult (aged 18-60) females at post-treatment and 3-month follow-up, of which 39 participants completed the study. Weight loss, eating psychopathology, food cue reactivity, and snacking behaviour were studied as main treatment outcomes, and mediators and moderators of treatment effects were studied. The presented study design represents an innovative effort to provide valuable clinical recommendations for the treatment of overeating and obesity.
authors.affiliation: Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: karolien.vandenakker@maastrichtuniversity.nl.
authors.forename: Karolien
authors.initials: K
authors.lastname: van den Akker
authors.affiliation: Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: ghislaine.schyns@maastrichtuniversity.nl.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Schyns
authors.affiliation: Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Anita
authors.initials: A
authors.lastname: Jansen
mesh_terms: D000293:Adolescent; D000328:Adult; D003463:Cues; D005260:Female; D005502:Food; D006801:Humans; D006963:Hyperphagia / Q000517:prevention & control* / Q000523:psychology; D007171:Implosive Therapy; D007266:Inhibition, Psychological; D007858:Learning; D008875:Middle Aged; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000523:psychology / Q000628:therapy; D055815:Young Adult
keywords: Expectancy violation; Exposure therapy; Inhibitory learning; Obesity; Weight loss