Pharmacological and Behavioral Treatment After Bariatric Surgery: Medication Change for Non-Responders (Stage 2b)

Study Overview
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Brief Summary
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This study will test the effectiveness of lisdexamfetamine medication as a treatment for loss-of-control eating and weight following bariatric surgery. This is a controlled test of whether, amongst non-responders to acute treatments, lisdexamfetamine medication results in superior outcomes compared with placebo.

Official Title
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Pharmacological and Behavioral Treatments to Treat Loss-of-Control Eating and Improve Weight Outcomes After Bariatric Surgery: Medication Change for Non-Responders (Stage 2b)

Conditions
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Loss-of-control Eating, Obesity/Overweight

Intervention / Treatment
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* Drug: Lisdexamfetamine Dimesylate (Medication)
* Other: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be in the age range ≥18 years of age and <65 years of age. Have had laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy Approximately ten months post-surgery Experienced regular loss of control eating about six months after bariatric surgery, and were considered treatment non-responders to a four-month treatment trial of medication and/or BWL Be an otherwise healthy subject without uncontrolled medical problems, as determined by the study physician and medical co-investigators (physical examination, laboratory studies). Read, comprehend, and write English at a sufficient level to complete study-related materials. Provide a signed and dated written informed consent prior to study participation. Be available for participation in the study for up to 15 months (3-month treatment plus 12-month follow up). Exclusion Criteria: Has a predisposition to seizures (e.g., subject with a history or evidence of seizure disorder, febrile seizures during childhood, brain tumor, cerebrovascular disease, or significant head trauma; has a family history of idiopathic seizure disorder or is currently being treated with medications or treatment regimens that lower seizure threshold). Has a history of anorexia nervosa or history of bulimia nervosa. Is currently using other medications for weight loss. Has a co-existing psychiatric condition that requires hospitalization or more intensive treatment (such as bipolar mood disorders, psychotic illnesses, or severe depression) Has untreated hypertension with a seated systolic blood pressure > 160 mmHg, diastolic blood pressure > 100 mmHg, or heart rate > 100 beats/minute. Has a history of congenital heart disease, cardiovascular disease, cardiac arrhythmias requiring medication, or a history of cerebrovascular pathology including stroke. Has current uncontrolled hypertension. Has current uncontrolled Type I or Type II diabetes mellitus. Has untreated hypothyroidism with a TSH > 1.5 times the upper limit of normal for the test laboratory with repeat value that also exceeds this limit. Has gallbladder disease. Has a history of severe renal, hepatic, neurological, chronic pulmonary disease, or any other unstable medical disorder. Is currently in active treatment for eating or weight loss. Is currently participating in another clinical study in which the subject is or will be exposed to an investigational or a non-investigational drug or device. Is breast-feeding or is pregnant or is not using a reliable form of birth control. Reports active suicidal or homicidal ideation. Previous history of problems with LDX or other stimulants. Has a history of allergy or sensitivity to LDX or other stimulant medications. Current medication contraindicated with study medication. Any current psychostimulant use or any medication for ADHD. History or current alcohol or substance use disorder (smoking will not be exclusionary) Is currently taking MAOI medication, SSRI medication, or strong inhibitors of CYP2D6

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 64 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Lisdexamfetamine dimesylate<br> | Drug: Lisdexamfetamine Dimesylate (Medication)<br>* Medication will be taken daily in pill form.<br>* Other names: Vyvanse;|
| Placebo Comparator: Placebo<br> | Other: Placebo<br>* Placebo will be inactive and taken daily in pill form.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Loss-of-Control Eating Frequency | Loss-of-control eating frequency is a continuous variable of loss-of-control eating episodes assessed using the Eating Disorder Examination interview; Loss-of-control eating frequency will be based on the past 28 days and defined as loss-of-control eating episodes per month. | From baseline interview at study enrollment to after the 12-week treatment | 
| Loss-of-Control Eating Frequency | Loss-of-control eating frequency is a continuous variable of loss-of-control eating episodes assessed using the Eating Disorder Examination interview; Loss-of-control eating frequency will be based on the past 28 days and defined as loss-of-control eating episodes per month. | From post-treatment to the 6-month follow-up | 
| Loss-of-Control Eating Frequency | Loss-of-control eating frequency is a continuous variable of loss-of-control eating episodes assessed using the Eating Disorder Examination interview; Loss-of-control eating frequency will be based on the past 28 days and defined as loss-of-control eating episodes per month. | From post-treatment to the 12-month follow-up | 
| Body Mass Index (BMI) | BMI is calculated using measured height and weight | From baseline at study enrollment to after the 12-week treatment | 
| Body Mass Index (BMI) | BMI is calculated using measured height and weight | From post-treatment to the 6-month follow-up | 
| Body Mass Index (BMI) | BMI is calculated using measured height and weight | From post-treatment to the 12-month follow-up |