Pharmacological and Behavioral Treatment After Bariatric Surgery: Acute (Stage 1)
Pharmacological and Behavioral Treatments to Treat Loss-of-Control Eating and Improve Weight Outcomes After Bariatric Surgery: Acute (Stage 1)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Participants who provide informed consent and are determined to be eligible will then participate in the study.
A total of 160 patients with obesity and regular LOC-eating following MBS will be randomly assigned (double-blind) in a balanced factorial (2 X 2) design, to one of four 16-week interventions: BWL+NB, BWL+Placebo, NB, or Placebo. The randomization will be in equal proportions but stratified by surgery type.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Valentina Ivezaj, Ph.D.
- Phone Number: 203-785-7210
- Email: valentina.ivezaj@yale.edu
Study Locations
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Connecticut
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New Haven, Connecticut, United States, 06510
- Yale Department of Psychiatry
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Be in the age range ≥18 years of age and ≤70 years of age.
- Have a BMI ≥30 (or BMI ≥27 with a medical comorbidity) and ≤50
- Have had laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy
- Approximately six months post-surgery
- Experience regular loss-of-control eating (defined as at least once weekly over the past 28 days)
- Be an otherwise healthy subject without uncontrolled medical problems, as determined by the study physician and medical co-investigators (physical examination, laboratory studies).
- Read, comprehend, and write English at a sufficient level to complete study-related materials.
- Provide a signed and dated written informed consent prior to study participation.
Be available for participation in the study for up to 19 months (7-month treatment plus 12-month follow up).
Exclusion Criteria:
- Has a predisposition to seizures (e.g., subject with a history or evidence of seizure disorder, febrile seizures during childhood, brain tumor, cerebrovascular disease, or significant head trauma; has a family history of idiopathic seizure disorder or is currently being treated with medications or treatment regimens that lower seizure threshold).
- Has a history of anorexia nervosa or history of bulimia nervosa.
- Is currently taking a medication that is a contraindication to NB medication (e.g., MAOI, opiates).
- Is currently using other medications for weight loss.
- Has a history of allergy or sensitivity to bupropion or naltrexone.
- Has a co-existing psychiatric condition that requires hospitalization or more intensive treatment (such as bipolar mood disorders, psychotic illnesses, or severe depression)
- Has untreated hypertension with a seated systolic blood pressure > 160 mmHg, diastolic blood pressure > 100 mmHg, or heart rate > 100 beats/minute.
- Has a history of congenital heart disease, cardiovascular disease, cardiac arrhythmias requiring medication, or a history of cerebrovascular pathology including stroke.
- Has current uncontrolled hypertension.
- Has current uncontrolled Type I or Type II diabetes mellitus.
- Has untreated hypothyroidism with a TSH > 1.5 times the upper limit of normal for the test laboratory with repeat value that also exceeds this limit.
- Has gallbladder disease.
- Has a history of severe renal, hepatic, neurological, chronic pulmonary disease, or any other unstable medical disorder.
- Has a recent history of drug or alcohol dependence (since having bariatric surgery).
- Is currently in active treatment for eating or weight loss.
- Is currently participating in another clinical study in which the subject is or will be exposed to an investigational or a non-investigational drug or device.
- Is breast-feeding or is pregnant or is not using a reliable form of birth control.
- Reports active suicidal or homicidal ideation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
Participants randomly assigned to this arm will receive 16 weeks of placebo.
Placebo will be inactive and taken daily in pill form.
|
Placebo will be inactive and taken daily in pill form.
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|
Experimental: Behavioral Weight Loss (BWL) + Naltrexone and Bupropion (NB) medication
Participants randomly assigned to this arm will receive 16 weeks of BWL counseling and NB medication.
The naltrexone and bupropion will be taken daily in pill form.
|
NB medication will be taken daily in pill form.
Other Names:
Behavioral Weight Loss (BWL) counseling includes weekly sessions.
|
|
Experimental: BWL + Placebo
Participants randomly assigned to this arm will receive 16 weeks of BWL counseling and placebo.
Placebo will be inactive and taken daily in pill form.
|
Placebo will be inactive and taken daily in pill form.
Behavioral Weight Loss (BWL) counseling includes weekly sessions.
|
|
Experimental: NB medication
Participants randomly assigned to this arm will receive 16 weeks of NB medication taken daily in pill form.
|
NB medication will be taken daily in pill form.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Loss-of-control Eating Frequency
Time Frame: Post-treatment (4 months)
|
Loss-of-control eating frequency is a continuous variable of loss-of-control eating episodes assessed using the Eating Disorder Examination interview; Loss-of-control eating frequency will be based on the past 28 days and defined as loss-of-control eating episodes per month.
|
Post-treatment (4 months)
|
|
Body Mass Index
Time Frame: Post-treatment (4 months)
|
BMI is calculated using measured height and weight
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Post-treatment (4 months)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Loss-of-control Eating Remission
Time Frame: Post-treatment (4 months)
|
Categorical: zero episodes/28 days
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Post-treatment (4 months)
|
|
Weight loss
Time Frame: Post-treatment (4 months)
|
Categorical: 5% weight loss
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Post-treatment (4 months)
|
|
Eating Disorder Psychopathology
Time Frame: Post-treatment (4 months)
|
Eating-disorder psychopathology is a continuous variable as assessed by the global score of the Eating Disorder Examination/Eating Disorder Examination-Questionnaire. Scores range from 0-6 (0=no eating-disorder psychopathology; 6=severe eating-disorder psychopathology).
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Post-treatment (4 months)
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Depressive Symptoms
Time Frame: Post-treatment (4 months)
|
Depressive symptoms is a continuous variable of depressive symptomatology as assessed by the self-report measure, the Patient Health Questionnaire - 9. Scores range from 0-27 (0=no depressive symptoms, 27=greater depressive symptoms).
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Post-treatment (4 months)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nutrition Disorders
- Overnutrition
- Body Weight
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Overweight
- Obesity
- Heterocyclic Compounds
- Heterocyclic Compounds, Fused-Ring
- Alkaloids
- Polycyclic Aromatic Hydrocarbons
- Polycyclic Compounds
- Heterocyclic Compounds, 4 or More Rings
- Naloxone
- Morphinans
- Opiate Alkaloids
- Heterocyclic Compounds, Bridged-Ring
- Phenanthrenes
- Naltrexone
- bupropion hydrochloride, naltrexone hydrochoride drug combination
Other Study ID Numbers
Other Study ID Numbers
- 2000029057
- R01DK126637-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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