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Publications of Christina Hopkins    :chronological  alphabetical  combined listing:

%% Journal Articles   
   Author = {Patel, ML and Hopkins, CM and Brooks, TL and Bennett,
   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},
   url = {},
   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
    (Archived by
             WebCite at},
   Doi = {10.2196/12209},
   Key = {fds341889}

   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},
   url = {},
   Abstract = {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.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.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.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}

   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
   Journal = {Obesity (Silver Spring, Md.)},
   Volume = {26},
   Number = {7},
   Pages = {1144-1152},
   Year = {2018},
   Month = {July},
   url = {},
   Abstract = {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.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.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.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
   Doi = {10.1002/oby.22209},
   Key = {fds335692}

   Author = {Pearl, RL and Hopkins, CH and Berkowitz, RI and Wadden,
   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},
   url = {},
   Abstract = {OBJECTIVE:This study tested a novel group-based,
             cognitive-behavioral intervention designed to reduce
             internalized weight stigma among individuals with obesity.
             METHODS: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. RESULTS: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. CONCLUSION:Including
             cognitive-behavioral strategies to address weight stigma in
             weight management programs could potentially reduce
             internalized weight stigma and enhance treatment
   Doi = {10.1007/s40519-016-0336-y},
   Key = {fds339872}

   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
   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},
   url = {},
   Doi = {10.1111/obr.12527},
   Key = {fds339837}

   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
   Journal = {Obesity (Silver Spring, Md.)},
   Volume = {25},
   Number = {2},
   Pages = {317-322},
   Year = {2017},
   Month = {February},
   url = {},
   Abstract = {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.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/m2 ) 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.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).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}

   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},
   url = {},
   Abstract = {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).The
             sample included 178 participants (mean age=44.2±11.2years;
             BMI=40.9±5.9kg/m2; 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.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.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}

   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
   Journal = {Obesity (Silver Spring, Md.)},
   Volume = {24},
   Number = {11},
   Pages = {2327-2333},
   Year = {2016},
   Month = {November},
   url = {},
   Abstract = {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.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.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).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}

   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},
   url = {},
   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}

   Author = {Janke, EA and Jones, E and Hopkins, CM and Ruggieri, M and Hruska,
   Title = {Catastrophizing and anxiety sensitivity mediate the
             relationship between persistent pain and emotional
   Journal = {Appetite},
   Volume = {103},
   Pages = {64-71},
   Year = {2016},
   Month = {August},
   url = {},
   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}

   Author = {Alfaris, N and Minnick, AM and Hopkins, CM and Berkowitz, RI and Wadden,
   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},
   url = {},
   Abstract = {INTRODUCTION: 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. AREAS COVERED: 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. EXPERT
             OPINION: 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}

   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},
   url = {},
   Abstract = {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.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.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.Clinical NCT02100995
             Date of Registration: March 2014.},
   Doi = {10.1186/1471-2458-14-621},
   Key = {fds326671}

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