Food related computerised attention training for obesity

INTERVENTION: After baseline assessment, participants will be randomly allocated to either Attention Bias Modification Training (ABMT), Mindfulness, Based Intervention (MBI) or a waiting list condition. To balance groups for body weight, randomisation will be stratified by BMI (above or below 30 kg/m2) and by gender. Participants assigned to either condition will be asked to attend the Institute of Psychiatry, Psychology and Neuroscience eight times during an 8‐week period (i.e. once a week). The ABMT condition will last approximately 30 min. per visit and will implicitly train participants to “look towards” low calorie food using a modified version of the anti‐saccade task while eye movements are recorded to assess participants' accuracy. The MBI (provided by a company called Headspace) will last approximately 20 min. per training and will guide participants through a series of breathing exercises focusing on the present moment. In addition, participants allocated to the MBI condition will be asked to bring their favourite food (snack) increasing in calorie content as the training progresses (i.e. low, medium and high calorie), and will be guided to mindfully analyse it, focusing on its characteristics before eating it. Participants from both training conditions will be asked to complete a Visual Analogue Scale (VAS) measuring hunger and craving. For home sessions, participants will be given a tablet (Asus ZenPad 10) with the allocated training for a daily 10 min session using an app based ABMT or Headspace. Participants allocated to the waiting list condition will be asked to wait for 8 weeks after baseline assessment and then they will be asked if they wish to receive either ABMT or MBI for 8 weeks. CONDITION: Overweight/obesity ; Nutritional, Metabolic, Endocrine ; Obesity PRIMARY OUTCOME: 1. The feasibility of conducting a large scale RCT of attention trainings in overweight/obese patients by assessing recruitment, attendance, and retention rates. An acceptability and credibility questionnaire will be administered at post‐assessment (i.e., week 8); 2. The quality, completeness, and variability of the outcome measures, determined using descriptive statistical analyses and graphical methods INCLUSION CRITERIA: 1. Male or female participants 2. 18 years old or older (women of childbearing age will be included) 3. BMI of >25kg/m2 4. Fluent in English 5. Informed consent (written and witnessed) SECONDARY OUTCOME: Weight, eating behaviour and cognition before and after trainings. Assessment of these outcome measures will include different self‐report questionnaires:; 1. Hunger, craving, mood, stress and anxiety levels, measured using the Visual Analogue Scale (VAS); 2. Eating behaviour and awareness, assessed using the Food Craving Questionnaire – Trait version (FCQ‐T), the Eating Disorders Examination Questionnaire (EDEQ), the Power of Food scale, the Mindful Eating Questionnaire (MEQ) and Mindful Awareness and Attention Scale (MAAS); 3. General psychopathology measured using the Depression, Anxiety and Stress Scale (DASS‐21) and the State and Trait Anxiety Inventory (STAI); 4. Quality of diet and calorie intake assessed using 24h dietary recall questionnaire; 5. BMI and body composition calculated by taking height and weight on the day of the assessment using a bioelectrical impedance scale; 6. Different components of attention (i.e. alerting, orienting and executive attention) assessed by the food‐Attention Network Task (Food‐ANT); 7. Attention bias for food, measured by a dot‐probe task while recording eye movements; 8. Preference of low vs high‐calorie food items, assessed using the food‐choice task ; 9. State levels of cue‐elicited food cravings, assessed using the Food Challenge Task; 10. Food intake measured by the Bogus Taste Test, where participants will be asked to rate different kinds of highly palatable food in terms of their visual attractiveness, smell and taste and will be told that they should try as much of the offered items as they like. Food consumption will be determined by weighing remaining food.?; ; All of these measures will be taken both at baseline assessment and post‐assessment (8 weeks) with the exception of the EDEQ and the Power of Food Scale, which will also be completed by participants at follow‐up (week 12). The size of the treatment effect on each outcome measure will be the difference in outcome data between conditions at post treatment (8 weeks) and follow‐up (12 weeks). Group differences will be estimated using linear mixed effects regression models, controlling for the baseline level of the outcome and the strata variable used in the randomisation.; ; The aim is not to determine significant group differences but to establish a suitably precise effect size for the primary outcome at the post treatment assessment. This estimate will be used to guide the sample size of a future efficacy trial.