Please select the eligibility criteria that correspond to the clinical trial below.
Title: Do Insulin Secretion or Genotype Pattern Predict Low Fat vs Low Carb Weight Loss Success?
Brief Summary: Genomics research is advancing rapidly, and links between genes and obesity continue to be discovered and better defined. A growing number of single nucleotide polymorphisms (SNPs) in multiple genes have been shown to alter an individual's response to dietary macronutrient composition. Based on prior genetic studies evaluating the body's physiological responses to dietary carbohydrates or fats, the investigators identified multi-locus genotype patterns with SNPs from three genes (FABP2, PPARG, and ADRB2): a low carbohydrate-responsive genotype (LCG) and a low fat-responsive genotype (LFG). In a preliminary, retrospective study (using the A TO Z weight loss study data), the investigators observed a 3-fold difference in 12-month weight loss for initially overweight women who were determined to have been appropriately matched vs. mismatched to a low carbohydrate (Low Carb) or low fat (Low Fat) diet based on their multi-locus genotype pattern. The primary objective of this study is to confirm and expand on the preliminary results and determine if weight loss success can be increased if the dietary approach (Low Carb vs. Low Fat) is appropriately matched to an individual' s genetic predisposition (Low Carb Genotype vs. Low Fat Genotype) toward those diets.


Options:
A: Inclusion Criteria:

* Age: \> 18 years of age
* Women: Pre-menopausal (self-report) and \<50 years of age
* Men: \<50 years of age
* BMI (body mass index): 27-40 kg/m2 (need to lose \>10% body weight to achieve healthy BMI)
* Body weight stable for the last two months, and not actively on a weight loss plan
* No plans to move from the area over the next two years
* Available and able to participate in the evaluations and intervention for the study period
* Willing to accept random assignment
* To enhance study generalizability, people on medications not noted below as specific exclusions can
* participate if they have been stable on such medications for at least three months
* Ability and willingness to give written informed
* No known active psychiatric illness

Exclusion Criteria:

Subjects with the following conditions will be excluded (determined by self-report):

* Pregnant, lactating, within 6 months post-partum, or planning to become pregnant in the next 2 years
* Diabetes (type 1 and 2) or history of gestational diabetes or on hypoglycemic medications for any other indication
* Prevalent diseases: Malabsorption, renal or liver disease, active neoplasms, recent myocardial infarction (\<6 months)(patient self-report and, if available, review of labs from primary care provider)
* Smokers (because of effect on weight and lipids)
* History of serious arrhythmias, or cerebrovascular disease
* Uncontrolled hyper- or hypothyroidism (TSH not within normal limits)
* Medications: Lipid lowering, antihypertensive medications, and those known to affect weight/energy expenditure
* Excessive alcohol intake (self-reported, \>3 drinks/day)
* Musculoskeletal disorders precluding regular physical activity
* Unable to follow either of the two study diets for reasons of food allergies or other (e.g., vegan)
* Currently under psychiatric care, or taking psychiatric medications
* Inability to communicate effectively with study personnel
B: Inclusion Criteria:

* Age 18 to 35 years
* Intending to be available for a 24 month intervention
* Affiliated with either University of California, San Diego (UCSD), San Diego State University (SDSU), or California State University, San Marcos (CSUSM) as a student, faculty, or staff
* Willing and able to use social media
* Willing and able to use a smartphone and text messaging
* Willing and able to use the wearable, scale, and corresponding app
* Willing and able to attend measurement visits over the 2 year intervention
* Willing and able to engage in moderate to vigorous physical activity
* Overweight or obese, but not severely obese (25 \>= BMI \< 40 kg/m2)

Exclusion Criteria:

* Any comorbidities of obesity that require a clinical referral including eating disorders, pseudotumor cerebri, sleep apnea or hypoventilation syndrome, orthopedic problems, and meeting American Diabetes Association criteria for diabetes
* Psychiatric or medical conditions that prohibit compliance with the study protocol
* Had a cardiovascular event (heart attack, stroke, episode of heart failure, or revascularization procedure) within the last 6 months
* Currently being treated for a malignancy (other than non-melanoma skin cancer)
* Currently being treated and/or have an eating disorder
* Planning to have a weight loss surgery in the next 24 months (e.g., liposuction, lap band, gastric bypass)
* Pregnant, gave birth within the last 6 months, currently lactating or breastfeeding within the last 3 months, or actively planning pregnancy within the next 24 months
* Prescribed physical activity and/or dietary changes
* Prescribed medications that alter weight
* Enrolled in or planning to enroll in a weight loss program during the study period
* Lost more than 15 pounds within the past 3 months
C: Inclusion Criteria:

* BMI between 30-40
* weight stable (not gained/lost more than 25 lbs in the past 6 months)
* not enrolled in any formal weight-loss program
* interested in losing weight
* willing and able to record dietary intake and weight for 6 months and wear an accelerometer
* willing to attend 8 weekly groups and 2 follow up assessments at the Northwestern Chicago campus
* expect to reside in the Chicago land area for the next 12 months

Exclusion Criteria:

* any unstable medical conditions (i.e. uncontrolled hypertension, diabetes, unstable angina pectoris, myocardial infarction, transient ischemic attack, cancer undergoing active treatment, a cerebrovascular accident within the past 6 months)
* history of insulin-dependent diabetes
* Crohn's disease
* diagnosis of obstructive sleep apnea requiring intervention
* required use of an assistive device for mobility (i.e. cane, wheelchair)
* BMI \> 40
* hospitalization for a psychiatric disorder within the past 5 years
* those at risk for adverse cardiovascular events with moderate intensity activity
* those currently taking weight loss medication or committed to following an incompatible dietary regimen
* women who are pregnant, trying to get pregnant, or lactating
* Bulimia Nervosa
* suicide ideation
* current binge eating disorder
* those currently taking medications known to cause weight gain (i.e. Prednisone, Depakote, Diebeta, Diabinese, Cardura, Inderal, Zyprexa)
* current substance abuse or dependence
* plantar fasciitis
* current substance and/or alcohol dependence
* depression
* ADHD
D: Inclusion Criteria:

* Body mass index (BMI) is \> 25 kg/m2 and \< 35 kg/m2.
* Willing to use cell phones provided by the PBRC or personal cell phones to take pictures of foods during the study and to receive messages from study personnel.
* Willing to wear an activity monitor on your shoe and to use the internet to send information as frequently as once daily.
* Willing to weigh on a scale provided by the PBRC as frequently as once per day
* Willing to accept random assignment to either the e-Health (RIDE group) or control group.
* Weight stable, defined as no greater than 4.4 lbs. (2 kg) weight change over the previous 60 days.

Exclusion Criteria:

* Diagnosed with a chronic disease that affects body weight, appetite, or metabolism, namely diabetes, cardiovascular disease, cancer, and thyroid diseases or conditions.
* Currently in a weight loss program.
* Unable to engage in moderate intensity exercise.
* Unable to diet or exercise due to your medical history or current health status.
* Current use of prescriptions or over-the-counter medications or herbal products that affect appetite, body weight, or metabolism (e.g., weight loss medications such as sibutramine, antipsychotic medications such as olanzapine, ephedrine, and diuretics).
* Diagnosed with uncontrolled hypertension (high blood pressure), defined as systolic blood pressure \>159 mmHg \& diastolic blood pressure \>99 mmHg.
* For females, current pregnancy, or plans to become pregnant in the duration of the study.

Answer: A