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

Open to people ages 18 years and up

1. Age: ≥ 18 years old
2. BMI 30-50 kg/m2
3. Own a smartphone with Apple iOS or Android OS
4. Baseline eating window ≥ 14 hours/day
5. 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.

1. Taking insulin or anti-diabetic medications within the last 6 months.
2. Manifest diabetes, defined as fasting glucose ≥ 126 mg/dL, HbA1c ≥ 6.5%, or diagnosis of diabetes.
3. Currently taking any medication that is meant for, or has known effect on, appetite or body weight
4. Pregnant or breast-feeding women.
5. Caregiver for a dependent requiring frequent nocturnal care/sleep interruptions. Shift workers with variable (e.g. nocturnal) hours.
6. Planned international travel (time zone changes) during study period.
7. Taking therapeutic anticoagulation which might increase risk of bleeding from adipose tissue biopsy
8. History of surgical intervention for weight loss.

9. History of eating disorder

   10. Currently enrolled in a weight-loss or weight-management program 11. On a special or prescribed diet for other reasons (e.g. Celiac disease) 12. Known inflammatory and/or rheumatologic disease 13. Active tobacco abuse or illicit drug use or history of treatment for alcohol abuse 14. History of bone marrow or solid organ transplant 15. History of heart failure 16. History of major adverse cardiovascular events (acute coronary syndrome (ACS),

   percutaneous coronary intervention, coronary artery bypass graft surgery, stroke/transient ischemic attack (TIA)).

   17. History of atrial fibrillation or atrial flutter 18. 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.

   19. 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)

   20. History of adrenal disease 21. History of cirrhosis 22. History of stage 4 or 5 chronic kidney disease or requiring dialysis 23. History of HIV/AIDS 24. Uncontrolled psychiatric disorder (including history of hospitalization for

   psychiatric illness).

   25. History of obstructive sleep apnea (not on stable positive pressure therapy or other

   treatment for at least 3 months prior to enrollment)

   26. 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)