Effect of Time-restricted Eating on Catecholamine-sensitivity of Adipose Tissue in Obese Adults

Prior treatment

• Taking insulin or anti-diabetic medications within the last 6 months.
• Currently taking any medication that is meant for, or has known effect on, appetite or body weight
• History of obstructive sleep apnea (not on stable positive pressure therapy or other treatment for at least 3 months prior to enrollment)

Other illness

• Taking therapeutic anticoagulation which might increase risk of bleeding from adipose tissue biopsy
• History of surgical intervention for weight loss.
• History of eating disorder
• On a special or prescribed diet for other reasons (e.g. Celiac disease)
• Known inflammatory and/or rheumatologic disease
• Active tobacco abuse or illicit drug use or history of treatment for alcohol abuse
• History of bone marrow or solid organ transplant
• History of heart failure
• History of major adverse cardiovascular events (acute coronary syndrome (ACS), percutaneous coronary intervention, coronary artery bypass graft surgery, stroke/transient ischemic attack (TIA)).
• History of atrial fibrillation or atrial flutter
• History of malignancy, other than non-melanoma skin cancer, that is currently being treated, or that has not been treated with definitive therapy and considered to be in remission.
• History of hypo- or hyperthyroidism requiring dose titration of thyroid replacement medication(s) within the past 3 months (i.e. hypothyroidism on a stable dose of thyroid replacement therapy is not an exclusion)
• History of adrenal disease
• History of cirrhosis
• History of stage 4 or 5 chronic kidney disease or requiring dialysis
• History of HIV/AIDS
• Uncontrolled psychiatric disorder (including history of hospitalization for psychiatric illness).

Lab values

• Manifest diabetes, defined as fasting glucose ≥ 126 mg/dL, HbA1c ≥ 6.5%, or diagnosis of diabetes.
• Abnormal screening labs: renal dysfunction (eGFR \< 30 ml/min/1.73 m2), anemia, hypo- or hyperthyroidism, coagulopathy, abnormal liver function (AST, ALT \> 3x upper limit of normal)

Other

• Pregnant or breast-feeding women.
• Caregiver for a dependent requiring frequent nocturnal care/sleep interruptions. Shift workers with variable (e.g. nocturnal) hours.
• Planned international travel (time zone changes) during study period.
• Currently enrolled in a weight-loss or weight-management program

• Age: ≥ 18 years old
• BMI 30-50 kg/m2
• Own a smartphone with Apple iOS or Android OS
• Baseline eating window ≥ 14 hours/day
• If patients are on cardiovascular medications (HMG CoA reductase inhibitors (statins), other lipid modifying drugs (including over the counter drugs such as red yeast rice and fish oil), anti-hypertensive drugs, no dose adjustments will be allowed during the study period.