Brain-Training Game Helps Overweight Avoid Unhealthy Food

Becky McCall

July 06, 2015

A computer brain-training game that aims to modify an individual's response to unhealthy snack foods has reduced calorie intake and facilitated weight loss in a small study conducted mainly in overweight/obese, middle-aged people.

Lead investigator Dr Natalia Lawrence, PhD, from the University of Exeter, United Kingdom, and her colleagues report their findings in the journal Appetite, published online June 15.

The participants used the online training game for 4 days over a 2-week period and achieved an average weight loss of 0.7 kg, consuming around 220 fewer kcal a day after participating, compared with the control arm.

Dr Lawrence told Medscape Medical News: "This is a new approach to treating obesity and could potentially apply to any impulses triggered by environmental stimuli. Any behavior…where someone experiences a strong craving or desire could, in theory, respond to this type of intervention."

The training effectively reprograms the participants' brain responses to certain high-calorie, unhealthy snack foods, which is an alternative approach to the usual way of managing obesity, which is based on patient education and self-control, Dr Lawrence explained

And a key feature of the study is that it was done in the "real world" and builds on earlier work performed in the laboratory, proving this approach is translatable, she noted.

Reprogramming the Brain's Reward System

"In this study, we're targeting the brain's…motor responses to food based on our understanding of how impulses are generated, and we are aiming to tackle the problem at its source," Dr Lawrence explained. "We want to avoid those strong impulses being triggered at all, so that individuals are not relying on…self-control as much."

The aim of the study was to examine the effect of the training in individuals with vulnerability factors for overeating and overweight, so the majority of participants (78%) were already overweight/obese (body mass index [BMI] > 25 kg/m2). But the researchers also included some people of a healthy weight who reported some unhealthy snacking habits and loss of control over their food intake.

In the computerized response-inhibition training, visual representation of foods was used because this is one of the primary senses that people rely on. Seeing food can rapidly trigger brain motor and reward responses "as well as salivary responses, which encourage us to eat.…These responses are relatively automatic and very fast, which is why they are hard to control," Dr Lawrence noted.

Using a double-blind design, participants were randomized to receive 10-minute sessions of the online game over 4 days of either active (n = 41) or control (n = 42) training.

In the active group, participants were trained to repeatedly avoid pressing on images of unhealthy food (eg, pizza) — so called "stop/no-go" — but to click on pictures of healthy foods ("go"). The control group completed the same "stop-vs-go" training, but involving pictures of nonfood objects (eg, pens).

Intervention Is Highly Acceptable; Larger Trials Planned

"Contrary to some expectations, weight loss was observed after 2 weeks," reported Dr Lawrence. "In fact, over the 2 weeks, the active group lost an average of 670 g and, based on their food diaries, which were converted to calories, they ate on average 220 kcal less in a 24-hour period."

The training also reduced how much the calorie-dense "stop" foods were liked.

The reduction in weight and unhealthy snacking in the active group was maintained 6 months after the study, according to participants' self-report.

The control group showed no effect on weight over the 2-week period but did report less snacking at 1 and 6 months. "We think this might have partly been due to self-monitoring via the snacking diary, which makes people [more] aware of their eating habits," added Dr Lawrence.

A high rate of adherence (97%) to the program and positive feedback suggested the intervention is highly acceptable. "Nearly 90% of people said they would continue with the training and recommend it to a friend," Dr Lawrence said.

As it could be made freely available online, "it has the potential to help reduce the burden of overweight and obesity in an accessible and cost-effective manner," she and her colleagues write.

The next step is to try the online program in a larger sample, and Dr Lawrence is currently collaborating with Dr Eric Stice, PhD, from the Oregon Research Institute, Eugene, where they hope to provide similar training and use functional MRI to record responses to food in the brain's reward regions.

The study was funded by the Wellcome Trust. Dr Lawrence has declared no relevant financial relationships. Disclosures for the coauthors are listed in the article.

Appetite. Published online June 25, 2015. Article

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