Publications of Christina Hopkins
%% Journal Articles
@article{fds360007,
Author = {Hopkins, CM and Miller, HN and Brooks, TL and Mo-Hunter, L and Steinberg, DM and Bennett, GG},
Title = {Designing Ruby: Protocol for a 2-Arm, Brief, Digital
Randomized Controlled Trial for Internalized Weight
Bias.},
Journal = {Jmir Research Protocols},
Volume = {10},
Number = {11},
Pages = {e31307},
Year = {2021},
Month = {November},
Abstract = {<h4>Background</h4>Weight bias internalization, also known
as weight self-stigma, is a serious health concern for
individuals with higher body weight. Weight bias
internalization is associated with the greater avoidance of
health care and health-promoting activities, disordered
eating, social isolation, and weight gain. Elevated weight
bias internalization has been associated with low
self-compassion, yet few investigations have explored
self-compassion as a potential mechanism for reducing
internalized weight bias.<h4>Objective</h4>Ruby is a 2-arm
randomized controlled trial that was designed to test the
efficacy of a 4-week digital self-compassion intervention to
reduce internalized weight bias compared with a wait-list
control.<h4>Methods</h4>Adults with elevated internalized
weight bias and a BMI of >30 kg/m<sup>2</sup> (N=80) were
recruited. Ruby is a standalone digital trial that will be
delivered entirely via a smartphone and will involve
web-based data collection and text messages. The
intervention content will include psychoeducation and daily
mindfulness practices with a focus on self-compassion and
body concerns. We will use intent-to-treat analyses to
examine changes in weight bias internalization throughout
time by treatment arm. The analyses will be conducted by
using one-way analysis of covariance models and linear mixed
models.<h4>Results</h4>The protocol was designed in May 2020
and approved in December 2020. Data collection is currently
underway.<h4>Conclusions</h4>Ruby will be the first digital
standalone, self-compassion-based intervention designed to
reduce internalized weight bias. Owing to its standalone
digital delivery, Ruby may be a highly scalable treatment
for internalized weight bias that can be delivered on its
own or combined with other treatments. We expect Ruby to be
accessible to many, as participants can access the digital
intervention at times of the day that are the most
convenient in their schedule and are not burdened by
in-person time commitments, which can be a barrier for
participants with competing demands on their time and
resources. If efficacious, Ruby will be poised to expand a
burgeoning body of literature related to psychological
intervention in this area.<h4>Trial registration</h4>ClinicalTrials.gov
NCT04678973; https://clinicaltrials.gov/ct2/show/NCT04678973.<h4>International
registered report identifier (irrid)</h4>DERR1-10.2196/31307.},
Doi = {10.2196/31307},
Key = {fds360007}
}
@article{fds350459,
Author = {Patel, ML and Hopkins, CM and Bennett, GG},
Title = {Early weight loss in a standalone mHealth intervention
predicting treatment success.},
Journal = {Obesity Science & Practice},
Volume = {5},
Number = {3},
Pages = {231-237},
Year = {2019},
Month = {June},
Abstract = {<h4>Objective</h4>Early weight loss is a strong predictor of
longer-term and clinically meaningful weight loss but has
not been studied in the context of mobile health ('mHealth')
interventions.<h4>Methods</h4>GoalTracker was a randomized
trial among adults (21-65 years) with overweight or obesity
comparing three 12-week standalone mHealth interventions for
weight loss. All arms received a free commercial mobile app
(MyFitnessPal) for daily self-monitoring of diet and/or
weight and a goal to lose 5% of weight by 3 months.
Collapsing across arms, this analysis examined participants
with a 1-month weight (<i>n</i> = 84), categorizing them
as either early responders (≥2% weight loss at 1 month)
or early non-responders (<2% weight loss at
1 month).<h4>Results</h4>Early responders - 36% of
participants - had greater per cent weight change at
3 months (-5.93% [95% confidence interval: -6.82%, -5.03%])
than early non-responders (-1.45% [-2.15%, -0.75%]), which
was sustained at 6 months (-5.91% [-7.33%, -4.48%] vs.
-1.28% [-2.37%, -0.19%]; <i>p</i>s < 0.0001). Over half
(57%) of early responders achieved ≥5% weight loss at
3 months vs. 11% of early non-responders. At 4 weeks,
self-monitoring frequency (weight/diet) was significantly
greater among early responders, which continued across
12 weeks.<h4>Conclusion</h4>Responding early to an mHealth
treatment is associated with higher engagement and greater
likelihood of achieving clinically meaningful weight
loss.},
Doi = {10.1002/osp4.329},
Key = {fds350459}
}
@article{fds341889,
Author = {Patel, ML and Hopkins, CM and Brooks, TL and Bennett,
GG},
Title = {Comparing Self-Monitoring Strategies for Weight Loss in a
Smartphone App: Randomized Controlled Trial.},
Journal = {Jmir Mhealth and Uhealth},
Volume = {7},
Number = {2},
Pages = {e12209},
Year = {2019},
Month = {February},
Abstract = {BACKGROUND:Self-monitoring of dietary intake is a valuable
component of behavioral weight loss treatment; however, it
declines quickly, thereby resulting in suboptimal treatment
outcomes. OBJECTIVE:This study aimed to examine a novel
behavioral weight loss intervention that aims to attenuate
the decline in dietary self-monitoring engagement.
METHODS:GoalTracker was an automated randomized controlled
trial. Participants were adults with overweight or obesity
(n=105; aged 21-65 years; body mass index, BMI, 25-45 kg/m2)
and were randomized to a 12-week stand-alone weight loss
intervention using the MyFitnessPal smartphone app for daily
self-monitoring of either (1) both weight and diet, with
weekly lessons, action plans, and feedback (Simultaneous);
(2) weight through week 4, then added diet, with the same
behavioral components (Sequential); or (3) only diet
(App-Only). All groups received a goal to lose 5% of initial
weight by 12 weeks, a tailored calorie goal, and automated
in-app reminders. Participants were recruited via online and
offline methods. Weight was collected in-person at baseline,
1 month, and 3 months using calibrated scales and via
self-report at 6 months. We retrieved objective
self-monitoring engagement data from MyFitnessPal using an
application programming interface. Engagement was defined as
the number of days per week in which tracking occurred, with
diet entries counted if ≥800 kcal per day. Other
assessment data were collected in-person via online
self-report questionnaires. RESULTS:At baseline,
participants (84/100 female) had a mean age (SD) of 42.7
(11.7) years and a BMI of 31.9 (SD 4.5) kg/m2. One-third
(33/100) were from racial or ethnic minority groups. During
the trial, 5 participants became ineligible. Of the
remaining 100 participants, 84% (84/100) and 76% (76/100)
completed the 1-month and 3-month visits, respectively. In
intent-to-treat analyses, there was no difference in weight
change at 3 months between the Sequential arm (mean -2.7 kg,
95% CI -3.9 to -1.5) and either the App-Only arm (-2.4 kg,
-3.7 to -1.2; P=.78) or the Simultaneous arm (-2.8 kg, -4.0
to -1.5; P=.72). The median number of days of
self-monitoring diet per week was 1.9 (interquartile range
[IQR] 0.3-5.5) in Sequential (once began), 5.3 (IQR 1.8-6.7)
in Simultaneous, and 2.9 (IQR 1.2-5.2) in App-Only. Weight
was tracked 4.8 (IQR 1.9-6.3) days per week in Sequential
and 5.1 (IQR 1.8-6.3) days per week in Simultaneous.
Engagement in neither diet nor weight tracking differed
between arms. CONCLUSIONS:Regardless of the order in which
diet is tracked, using tailored goals and a commercial
mobile app can produce clinically significant weight loss.
Stand-alone digital health treatments may be a viable option
for those looking for a lower intensity approach. TRIAL
REGISTRATION:ClinicalTrials.gov NCT03254953;
https://clinicaltrials.gov/ct2/show/NCT03254953 (Archived by
WebCite at http://www.webcitation.org/72PyQrFjn).},
Doi = {10.2196/12209},
Key = {fds341889}
}
@article{fds338001,
Author = {Hopkins, CM and Bennett, GG},
Title = {Weight-Related Terms Differentially Affect Self-Efficacy and
Perception of Obesity.},
Journal = {Obesity (Silver Spring, Md.)},
Volume = {26},
Number = {9},
Pages = {1405-1411},
Year = {2018},
Month = {September},
Abstract = {<h4>Objective</h4>Little work has explored the effect of
weight-related terms on treatment initiation; only one study
has investigated weight-related terms and the psychological
constructs associated with treatment uptake. The present
study examines the effects of four common weight-related
terms on treatment initiation and the moderating effect of
weight bias internalization.<h4>Methods</h4>Adult
participants with overweight and obesity (n = 436) were
recruited online and asked to read three vignettes
describing clinical encounters; the weight-related term
(i.e., "weight," "BMI," "obesity," or "fat") was varied
randomly. Participants then reported self-efficacy,
cognitive and emotional illness beliefs about obesity (i.e.,
illness perception), and interest in a weight loss
program.<h4>Results</h4>The term "obesity" resulted in the
greatest self-efficacy and perceived control over obesity.
"Fat" resulted in the least illness coherence (i.e.,
understanding of obesity). Weight bias internalization did
not moderate the effect of term on self-efficacy, nor did it
moderate illness perception. No differences in weight loss
program enrollment were observed.<h4>Conclusions</h4>Use of
the term "obesity" may promote patients' perceived control
and self-efficacy. Use of "fat" should be avoided. Results
suggest that, despite patient and clinician preference for
euphemistic weight terms, use of clinical language such as
"obesity" may perform better in provider
intervention.},
Doi = {10.1002/oby.22255},
Key = {fds338001}
}
@article{fds335692,
Author = {Faulconbridge, LF and Driscoll, CFB and Hopkins, CM and Bailer
Benforado, B and Bishop-Gilyard, C and Carvajal, R and Berkowitz, RI and DeRubeis, R and Wadden, TA},
Title = {Combined Treatment for Obesity and Depression: A Pilot
Study.},
Journal = {Obesity (Silver Spring, Md.)},
Volume = {26},
Number = {7},
Pages = {1144-1152},
Year = {2018},
Month = {July},
Abstract = {<h4>Objective</h4>Obesity and depression frequently
co-occur, and each increases risk for cardiovascular disease
(CVD). This study tested whether a combined treatment,
targeting obesity and depression simultaneously, would yield
greater improvements in weight, mood, and CVD risk factors
than treatments that targeted each disease
individually.<h4>Methods</h4>Seventy-six participants with
obesity and major depression were randomly assigned to (1)
behavioral weight control (BWC), (2) cognitive behavioral
therapy for depression (CBT-D), or (3) BWC combined with
CBT-D. Participants were provided 18 group treatment
sessions over 20 weeks. Mood, weight, and CVD risk were
assessed at baseline and weeks 8 and 20, with a follow-up
visit at week 46.<h4>Results</h4>At week 20, participants in
combined treatment lost significantly (P < 0.02) more
weight (5.2% ± 1.2%) than those assigned to CBT-D
(0.8% ± 1.3%) and comparable amounts as those in BWC
(3.5% ± 1.3%). Depression scores decreased
significantly from baseline levels in each group, with no
significant differences between groups. All three groups
showed significant improvements in 10-year CVD risk, with no
significant differences between groups. Groups did not
differ significantly on any of these measures at week
46.<h4>Conclusions</h4>BWC yielded short-term improvements
in weight, mood, and CVD risk, comparable to a combined
treatment that incorporated CBT-D. Results require
replication with a larger sample size.},
Doi = {10.1002/oby.22209},
Key = {fds335692}
}
@article{fds339872,
Author = {Pearl, RL and Hopkins, CH and Berkowitz, RI and Wadden,
TA},
Title = {Group cognitive-behavioral treatment for internalized weight
stigma: a pilot study.},
Journal = {Eating and Weight Disorders : Ewd},
Volume = {23},
Number = {3},
Pages = {357-362},
Year = {2018},
Month = {June},
Abstract = {<h4>Objective</h4>This study tested a novel group-based,
cognitive-behavioral intervention designed to reduce
internalized weight stigma among individuals with
obesity.<h4>Methods</h4>A total of eight men and women with
obesity who had experienced weight stigma and reported high
levels of internalized weight stigma attended the Weight
Bias Internalization and Stigma (BIAS) Program. The program
provided eight weekly sessions of cognitive-behavioral
treatment to cope with weight stigma. Participants completed
questionnaires pre- and post-intervention, including the
Weight Bias Internalization Scale (WBIS), Fat Phobia Scale,
Weight Efficacy Life-Style Questionnaire (WEL), and Beck
Depression Inventory-II (BDI-II). Six additional
participants were included in a quasi-control group that
received no intervention until after completing all study
measures.<h4>Results</h4>Participants in the Weight BIAS
Program reported significantly greater decreases in WBIS and
Fat Phobia scores, and greater increases in WEL scores than
participants in the quasi-control group (ps < .04).
Changes in BDI-II scores did not differ between groups.
Treatment-acceptability ratings were high among participants
who received the intervention.<h4>Conclusion</h4>Including
cognitive-behavioral strategies to address weight stigma in
weight management programs could potentially reduce
internalized weight stigma and enhance treatment
outcomes.},
Doi = {10.1007/s40519-016-0336-y},
Key = {fds339872}
}
@article{fds350460,
Author = {Hopkins, CM and Steinberg, D and Bennett, G},
Title = {WEIGHT CHANGE MEDIATES CHANGE IN DEPRESSION: RESULTS FROM
THE TRACK STUDY},
Journal = {Annals of Behavioral Medicine},
Volume = {52},
Pages = {S328-S328},
Publisher = {OXFORD UNIV PRESS INC},
Year = {2018},
Month = {April},
Key = {fds350460}
}
@article{fds350461,
Author = {Steinberg, D and Hopkins, C and Bennett, G},
Title = {INVESTIGATING "MAINTAIN, DON'T GAIN" APPROACHES TO WEIGHT
CONTROL FOR PATIENTS NOT READY OR INTERESTED IN WEIGHT
LOSS},
Journal = {Annals of Behavioral Medicine},
Volume = {52},
Pages = {S661-S661},
Publisher = {OXFORD UNIV PRESS INC},
Year = {2018},
Month = {April},
Key = {fds350461}
}
@article{fds339837,
Author = {Chao, AM and Loughead, J and Bakizada, ZM and Hopkins, CM and Geliebter,
A and Gur, RC and Wadden, TA},
Title = {Sex/gender differences in neural correlates of food stimuli:
a systematic review of functional neuroimaging
studies.},
Journal = {Obesity Reviews : an Official Journal of the International
Association for the Study of Obesity},
Volume = {18},
Number = {6},
Pages = {687-699},
Year = {2017},
Month = {June},
Doi = {10.1111/obr.12527},
Key = {fds339837}
}
@article{fds350462,
Author = {Hopkins, CM and Steinberg, DM and Bennett, GG},
Title = {PREFERRED WEIGHT TERMS AND WEIGHT DISSATISFACTION: A STUDY
OF BLACK WOMEN IN THE SHAPE TRIAL},
Journal = {Annals of Behavioral Medicine},
Volume = {51},
Pages = {S253-S254},
Publisher = {OXFORD UNIV PRESS INC},
Year = {2017},
Month = {March},
Key = {fds350462}
}
@article{fds339838,
Author = {Pearl, RL and Wadden, TA and Hopkins, CM and Shaw, JA and Hayes, MR and Bakizada, ZM and Alfaris, N and Chao, AM and Pinkasavage, E and Berkowitz, RI and Alamuddin, N},
Title = {Association between weight bias internalization and
metabolic syndrome among treatment-seeking individuals with
obesity.},
Journal = {Obesity (Silver Spring, Md.)},
Volume = {25},
Number = {2},
Pages = {317-322},
Year = {2017},
Month = {February},
Abstract = {<h4>Objective</h4>Weight stigma is a chronic stressor that
may increase cardiometabolic risk. Some individuals with
obesity self-stigmatize (i.e., weight bias internalization,
WBI). No study to date has examined whether WBI is
associated with metabolic syndrome.<h4>Methods</h4>Blood
pressure, waist circumference, and fasting glucose,
triglycerides, and high-density lipoprotein cholesterol were
measured at baseline in 178 adults with obesity enrolled in
a weight-loss trial. Medication use for hypertension,
dyslipidemia, and prediabetes was included in criteria for
metabolic syndrome. One hundred fifty-nine participants
(88.1% female, 67.3% black, mean BMI = 41.1
kg/m<sup>2</sup> ) completed the Weight Bias Internalization
Scale and Patient Health Questionnaire (PHQ-9, to assess
depressive symptoms). Odds ratios and partial correlations
were calculated adjusting for demographics, BMI, and PHQ-9
scores.<h4>Results</h4>Fifty-one participants (32.1%) met
criteria for metabolic syndrome. Odds of meeting criteria
for metabolic syndrome were greater among participants with
higher WBI, but not when controlling for all covariates
(OR = 1.46, 95% CI = 1.00-2.13, P = 0.052).
Higher WBI predicted greater odds of having high
triglycerides (OR = 1.88, 95% CI = 1.14-3.09,
P = 0.043). Analyzed categorically, high (vs. low) WBI
predicted greater odds of metabolic syndrome and high
triglycerides (Ps < 0.05).<h4>Conclusions</h4>Individuals
with obesity who self-stigmatize may have heightened
cardiometabolic risk. Biological and behavioral pathways
linking WBI and metabolic syndrome require further
exploration.},
Doi = {10.1002/oby.21716},
Key = {fds339838}
}
@article{fds339839,
Author = {Chao, AM and Shaw, JA and Pearl, RL and Alamuddin, N and Hopkins, CM and Bakizada, ZM and Berkowitz, RI and Wadden, TA},
Title = {Prevalence and psychosocial correlates of food addiction in
persons with obesity seeking weight reduction.},
Journal = {Comprehensive Psychiatry},
Volume = {73},
Pages = {97-104},
Year = {2017},
Month = {February},
Abstract = {<h4>Introduction</h4>Food addiction is a controversial
concept. The potential influence of food addiction on
patients' psychosocial functioning and well-being has not
been well established. The purpose of this study was to
examine the relationships between psychosocial functioning
(depressive symptoms and health-related quality of life
[HRQOL]) and food addiction as measured by the Yale Food
Addiction Scale (YFAS). We also explored whether food
addiction contributed additional variance in explaining
psychosocial functioning, beyond demographic and clinical
factors (e.g., binge eating).<h4>Methods</h4>The sample
included 178 participants (mean age=44.2±11.2years;
BMI=40.9±5.9kg/m<sup>2</sup>; 88.2% female; 70.8% Black)
with obesity seeking treatment for weight loss. Participants
completed the Medical Outcomes Study 36-Item Short-Form
Health Survey, Impact of Weight on Quality of Life-Lite,
Patient Health Questionnaire, YFAS, and Questionnaire on
Eating and Weight Patterns-5.<h4>Results</h4>Twelve (6.7%)
participants met criteria for food addiction, with 4 (33.3%)
of these participants having co-occurring binge eating
disorder. After adjusting for covariates, the number of food
addiction symptoms accounted for 6.5% to 16.3% of additional
variance in general HRQOL, 5.0% to 21.5% in weight-related
HRQOL, and 19.1% in symptoms of depression.<h4>Conclusions</h4>In
this treatment-seeking sample of participants, we found a
low prevalence of food addiction, suggesting that
addictive-like eating is unlikely to be a causal mechanism
for most people with obesity. However, individuals who met
criteria for food addiction had reduced psychosocial
functioning compared to those who did not meet criteria.
Individuals with addictive-like eating may require
additional psychosocial support.},
Doi = {10.1016/j.comppsych.2016.11.009},
Key = {fds339839}
}
@article{fds339840,
Author = {Chao, AM and Wadden, TA and Faulconbridge, LF and Sarwer, DB and Webb,
VL and Shaw, JA and Thomas, JG and Hopkins, CM and Bakizada, ZM and Alamuddin, N and Williams, NN},
Title = {Binge-eating disorder and the outcome of bariatric surgery
in a prospective, observational study: Two-year
results.},
Journal = {Obesity (Silver Spring, Md.)},
Volume = {24},
Number = {11},
Pages = {2327-2333},
Year = {2016},
Month = {November},
Abstract = {<h4>Objective</h4>A previous study reported that
preoperative binge-eating disorder (BED) did not attenuate
weight loss at 12 months after bariatric surgery. This
report extends the authors' prior study by examining weight
loss at 24 months.<h4>Methods</h4>A modified
intention-to-treat population was used to compare 24-month
changes in weight among 59 participants treated with
bariatric surgery, determined preoperatively to be free of a
current eating disorder, with changes in 33 surgically
treated participants with BED. Changes were also compared
with 49 individuals with obesity and BED who sought
lifestyle modification for weight loss. Analyses included
all available data points and were adjusted for
covariates.<h4>Results</h4>At month 24, surgically treated
patients with BED preoperatively lost 18.6% of initial
weight, compared with 23.9% for those without BED (P =
0.049). (Mean losses at month 12 had been 21.5% and 24.2%,
respectively; P = 0.23.) Participants with BED who received
lifestyle modification lost 5.6% at 24 months, significantly
less than both groups of surgically treated patients (P <
0.001).<h4>Conclusions</h4>These results suggest that
preoperative BED attenuates long-term weight loss after
bariatric surgery. We recommend that patients with this
condition, as well as other eating disturbances, receive
adjunctive behavioral support, the timing of which remains
to be determined.},
Doi = {10.1002/oby.21648},
Key = {fds339840}
}
@article{fds326668,
Author = {Allison, KC and Spaeth, A and Hopkins, CM},
Title = {Sleep and Eating Disorders.},
Journal = {Current Psychiatry Reports},
Volume = {18},
Number = {10},
Pages = {92},
Year = {2016},
Month = {October},
Abstract = {Insomnia is related to an increased risk of eating
disorders, while eating disorders are related to more
disrupted sleep. Insomnia is also linked to poorer treatment
outcomes for eating disorders. However, over the last
decade, studies examining sleep and eating disorders have
relied on surveys, with no objective measures of sleep for
anorexia nervosa or bulimia nervosa, and only actigraphy
data for binge eating disorder. Sleep disturbance is better
defined for night eating syndrome, where sleep efficiency is
reduced and melatonin release is delayed. Studies that
include objectively measured sleep and metabolic parameters
combined with psychiatric comorbidity data would help
identify under what circumstances eating disorders and sleep
disturbance produce an additive effect for symptom severity
and for whom poor sleep would increase risk for an eating
disorder. Cognitive behavior therapy for insomnia may be a
helpful addition to treatment of those with both eating
disorder and insomnia.},
Doi = {10.1007/s11920-016-0728-8},
Key = {fds326668}
}
@article{fds326669,
Author = {Janke, EA and Jones, E and Hopkins, CM and Ruggieri, M and Hruska,
A},
Title = {Catastrophizing and anxiety sensitivity mediate the
relationship between persistent pain and emotional
eating.},
Journal = {Appetite},
Volume = {103},
Pages = {64-71},
Year = {2016},
Month = {August},
Abstract = {Stress-induced or "emotional eating" contributes to
increased caloric intake and weight gain, yet models
examining psychosocial factors that promote and sustain this
behavior are incomplete. There is a need to identify
explicit, clinically-relevant mechanisms of emotional eating
behavior. Pain is a common stressor associated with
increased weight and, potentially, altered eating behaviors.
The present study applies the Fear Avoidance Model (FAM) of
pain to examine processes that may explain the relationship
between pain and increased weight while also providing the
opportunity to examine specific mechanisms that may
encourage eating during a variety of stressors. Our aim is
to better understand the impact of pain on eating behavior
and the potential for the FAM to improve our understanding
of the psychological mechanisms that promote eating during
times of duress. A survey of 312 adults explored the link
between pain experience and stress-induced eating, further
examining the mediating effects of the psychological aspects
of the FAM (e.g., anxiety sensitivity, catastrophizing, and
pain-related fear). 24% of respondents reported persistent
pain, and had significantly higher BMIs than their pain-free
peers. All three FAM components were positively correlated
with measures of emotional, external, and restrained eating.
Anxiety sensitivity and catastrophizing significantly
mediated the relationship between persistent pain and
emotional eating behavior, while anxiety sensitivity alone
mediated the relationship between persistent pain and
external eating. Findings suggest pain may be associated
with increased likelihood for emotional eating and that
characteristics from FAM, in particular anxiety sensitivity
and catastrophizing, may mediate the relationship between
the presence of persistent pain and emotional eating
behavior. Evidence-based treatments targeting anxiety
sensitivity and catastrophizing could be useful to address
emotional eating in individuals struggling with both weight
and chronic pain.},
Doi = {10.1016/j.appet.2016.03.022},
Key = {fds326669}
}
@article{fds326670,
Author = {Alfaris, N and Minnick, AM and Hopkins, CM and Berkowitz, RI and Wadden,
TA},
Title = {Combination phentermine and topiramate extended release in
the management of obesity.},
Journal = {Expert Opinion on Pharmacotherapy},
Volume = {16},
Number = {8},
Pages = {1263-1274},
Year = {2015},
Month = {June},
Abstract = {<h4>Introduction</h4>Losing ≥ 5% of initial weight
improves quality of life and risk factors for cardiovascular
disease (CVD) in obese individuals. Lifestyle modification,
the cornerstone of weight reduction, may be complemented by
pharmacotherapy. In 2012, the FDA approved the combination
of phentermine and topiramate extended release (ER) for
chronic weight management, as an adjunct to lifestyle
modification.<h4>Areas covered</h4>This review examines the
safety and efficacy of phentermine-topiramate ER, as
determined by randomized controlled trials (RCTs). A
preliminary study confirmed the benefit of combining the two
medications for improving weight loss and reducing adverse
effects, as compared to using equivalent-dose monotherapy
alone.<h4>Expert opinion</h4>Across RCTs, groups prescribed
phentermine 15 mg/topiramate ER 92 mg lost an average of 10%
of initial weight, ∼ 8% more than placebo and 2% more than
phentermine 7.5 mg/topiramate 46 mg. Weight loss reduced the
risk of developing type 2 diabetes and improved CVD risk
factors. Phentermine-topiramate ER, however, was associated
with increased heart rate, the clinical significance of
which is being investigated in an FDA-required CVD outcomes
study. The medication also must be used with caution in
women of child-bearing age because of an increased risk to
infants of oral cleft.},
Doi = {10.1517/14656566.2015.1041505},
Key = {fds326670}
}
@article{fds326671,
Author = {Janke, EA and Fritz, M and Hopkins, C and Haltzman, B and Sautter, JM and Ramirez, ML},
Title = {A randomized clinical trial of an integrated behavioral
self-management intervention Simultaneously Targeting
Obesity and Pain: the STOP trial.},
Journal = {Bmc Public Health},
Volume = {14},
Number = {1},
Pages = {621},
Year = {2014},
Month = {June},
Abstract = {<h4>Background</h4>Obesity often occurs co-morbid with
chronic, non-cancer pain. While behavioral treatments have
proved effective for pain management and weight loss
independently, integrated interventions are lacking. The
study Simultaneously Targeting Obesity and Pain (STOP) is a
prospective, pragmatic, randomized controlled trial that
aims to determine whether overweight/obese individuals with
chronic pain who are randomized to receive an integrated
treatment Simultaneously Targeting Obesity and Pain (STOP)
will show more weight loss and greater reduction in pain
intensity over a 6-month period and greater maintenance at
12 months than those who receive standard care behavioral
weight loss or standard care behavioral pain management. We
hypothesize that individuals randomized to receive the STOP
treatment will demonstrate improved weight loss, pain
reduction, and maintenance compared to standard care
treatment approaches.<h4>Methods/design</h4>Adults
aged ≥ 18 with a body mass index ≥ 25 and who
report persistent pain (≥4 out of 0-10
for > 6 months) will be recruited for treatment at the
Health Behavior Research Lab at the University of the
Sciences. After baseline assessments and goal setting,
participants will be randomized to receive one of three
treatments. Participants will receive eleven treatment
sessions delivered during 1 hour, weekly individual
meetings with a clinic therapist. Follow-up will occur at 3,
6 and 12-month time points; assessments will include
measures of weight and pain intensity (primary outcomes). A
mixed-method approach to evaluating study outcomes will
include individual interviews with participants about their
treatment experience. These interviews will be led by a
research staffer who was not involved in study intervention
or assessment using a semi-structured discussion
guide.<h4>Discussion</h4>This study fills an important gap
in intervention research, evaluating best-practices for
behavioral management of a highly prevalent co-morbidity
that has sub-optimal outcomes with currently-implemented
approaches. STOP's pragmatic focus builds upon treatments
already in use in clinical practice. Should STOP be found
efficacious in achieving the dual outcomes of pain
management and weight loss, such an approach could be
integrated into practice with minimal additional cost or
training.<h4>Trial registration</h4>Clinical Trials.gov
NCT02100995 Date of Registration: March 2014.},
Doi = {10.1186/1471-2458-14-621},
Key = {fds326671}
}