Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Controlled Trial of Lifestyle Interventions to Control Weight After Bariatric Surgery
Brief Summary: This randomized controlled trial is designed to test the feasibility and efficacy of a novel 10-week mindfulness-based intervention (MBI) on weight maintenance as well as behavioral and psychosocial outcomes in patients who have undergone bariatric surgery.

Primary hypothesis:

Bariatric patients who have stopped losing weight (\< 5 lbs weight loss in past month) 1-5 years post-surgery will be willing to participate in this 10-week intervention. The investigators expect a high adherence rate (\>70%) and no issues with meeting recruitment goals.

Secondary hypotheses:

Patients assigned to the MBI will show greater improvement in a) weight control (defined by differences in body weight between baseline and follow-up); b) eating behaviors (binge eating, emotional eating); and c) psychosocial measures (quality of life, depression, perceived stress, eating self-efficacy, coping ability) than a standard lifestyle intervention (1 hr lifestyle counseling).

Patients assigned to the MBI intervention will show greater improvement in biomarkers of stress and inflammation \[salivary cortisol, high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha)\] as compared with a standard lifestyle intervention.

Food-related attentional bias as measured by the food-related Stroop task will be differentially affected among patients assigned to the MBI as compared with the intensive lifestyle intervention and standard lifestyle intervention.


Options:
A: Inclusion Criteria:

* Adult aged between 18 and 65 years
* Obese (BMI \>= 30)
* Recruited from the nutrition pole of Ambroise Paré Hospital
* Diagnosed with Binge-Eating Disorder (BED) according to DSM5 criteria
* Informed consent provided during inclusion interview

Exclusion Criteria:

* Already participating in a clinical trial
* Bariatric surgery patients (except for gastric band removed at least 3 years before)
* Planned bariatric surgery
* Central obese (genetic)
* Pregnant women
* No internet access at home
* Difficulties to understand French language
* Patients under social protection
* Cognitive dysfunctions in understanding simple guidelines provided by the paramedical staff (e.g., diet or exercise guidelines)
* Auditory disorders not allowing to hear audio files
* Blurred vision not allowing to use Internet
B: Inclusion Criteria:

* Women with overweight or obesity (BMI above 25);
* Enrolled in nutritional treatment for weight loss in primary care units and Hospitals from Coimbra

Exclusion Criteria:

* Binge Eating Disorder assessed through Eating Disorders Examination Interview;
* Severe psychiatric problems (severe depressive episode, substance abuse, Bipolar disorder and Borderline Personality Disorder) assessed through Structured Clinical Interview for DSM Disorders (SCDI-I and SCID-II);
* medical conditions that affect weight;
* medication that can cause significant weight or appetite changes.
C: Inclusion Criteria:

* Age 18+ years old
* BMI \> 30-45
* Waist circumference \> 102 cm (men) or \> 88 cm (women)
* Live in San Francisco Bay Area and able to attend more than 16 classes and up to 12 assessment visits in San Francisco over an 18 month period

Exclusion Criteria:

* Inability to provide informed consent
* Age \< 18
* A substance abuse, mental health, or medical condition that, in the opinion of investigators, will make it difficult for the potential participant to participate in the group intervention
* Type I or II Diabetes or fasting glucose ≥ 126 mg/dl or hemoglobin A1c ≥ 6.5; those with HbA1c between 6-6.5% may complete an OGTT to rule out diabetes (glucose \<200 mg/dl)
* Use of systemic (oral or IV) corticosteroids in the 6 months prior to enrollment or severe autoimmune disorders or other conditions (e.g. rheumatoid arthritis, lupus), that are likely to require these medications
* Use of immunosuppressive or immunomodulating drugs or chronic or acute conditions that would require the use of such medications
* A history of known coronary artery disease (CAD), or typical or atypical anginal chest pain requires a letter from the participant's physician that he or she has been adequately evaluated and that a moderate exercise program is appropriate
* Non English speaker
* Pregnant or planning to get pregnant in the next 12 months, breastfeeding or less than 6 months post-partum
* Initiation of new class of psychiatric medications in past 2 months
* Currently on a specific weight loss diet
* For influenza vaccine administration: a prior allergic reaction to the influenza vaccine or eggs. These participants can be included in the trial but will be excluded from participation in influenza vaccination.
* Active bulimia or strong history of bulimia
* Current use of weight loss medications or supplements such as amphetamine-based drugs that are believed to have some effect on weight
* History of or planned weight loss surgery
* Untreated hypothyroidism: TSH \> 4mU/mL (or the upper limit of normal reference defined by the lab doing the assay)
D: Inclusion Criteria:

1. Patients who have undergone bariatric surgery 1-5 years prior to study start (by medical record and/or self report)
2. Weight loss plateau (\< 5 lbs weight loss in past month) (by medical report and/or self report)
3. Ages 18-65 years (by medical record and/or self report)
4. Able to complete outcome assessments

Exclusion Criteria:

1. Prior experience with meditation course (past 6 months), current mindfulness/meditation practice, or regular meditation or mindfulness practice in past year ("Regular practice" defined as practicing formally 1 or more times a week for 2 months).
2. Plans to leave the study area within next 12 months
3. Serious psychiatric illness or personality disorder (by medical record and/or self-report)
4. Current alcohol and/or substance abuse
5. Pregnancy or plans to become pregnant in next year
6. Non-English speaking
7. \> 1 prior weight loss surgery (by medical record and self-report)
8. Gastric band removed prior to study contact.

Answer: D