Examining Loss of Control Eating in Black Adolescents with Overweight/Obesity: The Role of Social Contexts and Social Stress

University Of Connecticut Storrs, Storrs-Mansfield CT

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Abstract

Rates of obesity for Black adolescents are among the highest of any racial or ethnic group in the United States, and loss of control over eating (LOC; being unable to control what or how much one is eating) confers greater risk for the development and maintenance of excess weight. LOC occurs in 25-44% of Black youth with overweight and obesity, and Black youth eat more calories than their White counterparts during LOC episodes, compounding the risk of excess weight gain. Nevertheless, existing explanatory models of LOC do not capture the unique social contexts in which LOC occurs in Black youth, specifically the social nature of LOC in this population and the role of demographic-based social stress (DBSS), which occurs as a result of experiencing negative treatment because of unalterable characteristics like race. Using a synthesis of qualitative data and ecological momentary assessment, this K23 proposal seeks to understand the social contexts in which LOC occurs in Black adolescents, and specifically to probe the association between DBSS and LOC. Focus groups (k = 6-8; N=24-48) will first be employed to gain a qualitative understanding of the contexts in which LOC occurs, the specific language that youth use to describe it, and how it may be linked to DBSS. Through an iterative process, data from these groups will be used to inform the EMA protocol in a second set of adolescents with concurrent OWOB and LOC (N = 50), which will assess the interplay between individual vulnerabilities for LOC and the larger social context, including DBSS. To carry out this K23, I will receive mentorship from a leading team of experts in the areas of obesity and eating disorders, public health, and ecological momentary assessment. This K23 will specifically facilitate my training in assessment of LOC that reflects the cultural experiences of youth from different backgrounds, engagement in community-involved research, and design and conduct of EMA research. This training will enable me to achieve my long-term goal of becoming a leading independent investigator focused on understanding the large-scale contextual factors that drive obesity-related health outcomes in youth from varied racial and ethnic backgrounds. Additionally, executing this K23 will also enable me to achieve two short-term goals: 1) submitting a subsequent R03 to create a brief, psychometrically- sound measure of LOC that can be used to identify this problematic behavior in both research and clinical settings and 2) extending the findings from this K23 to understand how race interacts with other areas of identity (e.g., socioeconomic status) to influence LOC and weight gain in youth from varied racial and ethnic backgrounds. This K23 proposal will serve as a launching point for my career as I leverage the training and research skills afforded by this award to become a leader in the field of adolescent obesity prevention and intervention.