Working Memory in Overweight Children With and Without Loss of Control Eating

Neural Substrates of Context-dependent Working Memory in Youth With Overweight/Obesity and Loss of Control Eating

Loss of control (LOC) eating in children is associated with multiple physical and mental health impairments, including obesity and eating disorders. Little is known about the developmental neurobiology of LOC, which is crucial to specifying its pathophysiology and the development of effective preventive interventions. Individual differences in working memory (WM) appear to be related to LOC eating and excess weight status in youth, but the specificity and neural correlates of these individual differences are unclear. Failure to adequately understand the nature of associations between WM and eating behavior in children with overweight/obesity limits the development of appropriately-targeted, neuro-developmentally informed interventions addressing problematic eating and related weight gain in youth. To close this clinical research gap, the current study proposes to investigate the context-dependence of WM impairment and its neural correlates in children with concomitant overweight/ obesity and LOC eating as compared to their overweight/obese peers.

Specific aims are to investigate:

1)WM performance in youth with LOC eating relative to overweight/obese controls during recalls in the context of food-related versus neutral distractors; and 2) neural activation patterns during WM performance across both food-related and neutral stimuli. We hypothesize that, relative to their overweight/obese peers, youth with LOC eating will show 1) more errors and slower response times during recalls involving food-related vs. neutral distractors, and fewer errors and faster response times during recalls involving food-related vs. neutral targets; 2) increased activation in prefrontal regions during WM performance across stimuli types relative to overweight/obese controls, and 3) even greater activation in the context of food-related versus neutral distractors.

The proposed study is the first to use state-of-the-science neuroimaging methodology to clarify the relations between WM and LOC eating, with strong potential to advance understanding of the associations among executive functioning, excess weight status, and eating pathology, and inform the development of interventions (e.g., WM training) to alleviate their cumulative personal and societal burden.

Study Overview

• Status: Completed
• Conditions: Pediatric Obesity; Binge Eating
• Intervention / Treatment: Other: Observational

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• United States
  • Rhode Island
    • Providence, Rhode Island, United States, 02903
      • Weight Control & Diabetes Research Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 10 years to 17 years (Child)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Participants will be 30 children, ages 10-17, 15 of whom who are overweight/obese and report loss of control eating (i.e., at least 3 objectively or subjectively large loss of control episodes in the past 3 months), and 15 of whom who will serve as overweight/obese controls.

Description

Inclusion Criteria:

• Overweight/Obese (>85% expected body mass)
• Right-handed

Exclusion Criteria:

• Currently taking any medications known to affect their weight/appetite
• Report current or past medical or psychiatric conditions known to significantly affect eating or weight (e.g., diabetes, bulimia nervosa), with the exception of binge eating disorder
• Have an intelligence quotient (IQ) in the borderline range or lower, or any condition affecting executive functioning (e.g., recent concussion, history of traumatic brain injury)
• Are unable to read or comprehend study materials
• Are receiving concurrent treatment for overweight/obesity
• Have metallic foreign bodies, face or neck tattoos, or other conditions that would prohibit fMRI scanning

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Overweight/Obesity Control; Adolescents who have overweight/obesity, but do not report loss of control eating.	Other: Observational; Observational data will be obtained through participant self-response, parental response, cognitive performance, and neural imaging.
Overweight/Obesity Experimental; Adolescents who have overweight/obesity, and report loss of control eating.	Other: Observational; Observational data will be obtained through participant self-response, parental response, cognitive performance, and neural imaging.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
BMI	Body Mass Index calculated with height/weight (cm/g)	1 day
Eating Behavior	Eating behavior will be assessed using the Eating Disorders Examination (EDE), a semi-structured interview.	1 day
Neural Activity	Neural activation will be assessed using functional magnetic resonance imaging (fMRI) data	Up to 2 weeks
Working Memory	Working memory will be assessed using the NIH Toolbox list sort task.	1 day

Collaborators and Investigators

• Sponsor: The Miriam Hospital
• Collaborators: Brown University
• Investigators: Principal Investigator: Andrea B. Goldschmidt, Ph.D., Warren Alpert Medical School of Brown University

Study record dates

Study Major Dates

• Study Start (Actual): October 18, 2018
• Primary Completion (Actual): December 31, 2020
• Study Completion (Actual): December 31, 2020

Study Registration Dates

• First Submitted: October 2, 2019
• First Submitted That Met QC Criteria: October 3, 2019
• First Posted (Actual): October 7, 2019

Study Record Updates

• Last Update Posted (Actual): February 23, 2021
• Last Update Submitted That Met QC Criteria: February 22, 2021
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Keywords: Loss of Control Eating; Working Memory
• Additional Relevant MeSH Terms: Signs and Symptoms, Digestive; Overnutrition; Nutrition Disorders; Body Weight; Hyperphagia; Obesity; Pediatric Obesity; Bulimia; Overweight
• Other Study ID Numbers: 1205595

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No