Eating in the Absence of Hunger and Body Mass Index: Contextual Effects of Stress and Parenting Pubblico
Hampton, Joya (Summer 2018)
Abstract
Obesity is a nationwide health concern which reflects significant disparities by race and ethnicity. In particular, African-American children have higher rates of overweight and obesity compared to children of other racial and ethnic groups. Further, dropout rates and treatment compliance are lower among African-Americans in pediatric weight management programs. Aside from the already identified public health issues that contribute to obesity development in this population, psychological factors may also play an important role in contributing to obesity disparity rates. Stress and parenting are two important constructs that are influenced by one’s culture and have been determined to influence obesity development via direct and indirect mechanisms—they are also impacted by socioeconomic status. If those variables contribute significantly to eating behavior and body size, then increased focus might be placed on addressing psychological factors as treatment targets for this high-risk group. However, if those variables do not contribute significantly todifferential risk, then greater focus on access to treatment and improved retention for this high-risk group may be the most cost-effective approach. The purpose of this study was to investigate the impact of stress and parenting variables on maladaptive eating behavior within a treatment-seeking sample of overweight/obese children. Models of differential risk (based on self-identified ethnicity and socioeconomic status) were used to assess the degree to which stress and parenting variables add explanatory power in understanding maladaptive eating behaviors in a treatment-seeking sample. Ninety parent-child dyads were recruited from a hospital-based pediatric weight management program. Authoritarian parenting style and parental feeding style predicted eating in the absence of hunger due to fatigue or boredom, and there were direct relationships between perceived stress and eating in the absence of hunger due to negative affect. The pattern of findings was similar across racial groups. However, within group correlational analyses indicated some differential associations among study variables by race/ethnicity. Study results suggest further investigation of the influence of parenting and stress variables is warranted but support the conclusion that issues related to access and retention may be even more important to address in order to enhance the success of African-American families in pediatric weight management programs.
Table of Contents
INTRODUCTION ........................................................................................................... 9
PARENTING STYLE AND PARENT FEEDING PRACTICES ................................................12
STRESS AND STRESS COPING ........................................................................................14
INFLUENCE OF INCOME AND ETHNICITY ON EATING BEHAVIOR, PARENTING, AND STRESS .........15
TREATMENT-SEEKING FAMILIES...........................................................................................20
GAPS IN THE LITERATURE......................................................................................21
AIMS AND HYPOTHESES .......................................................................................21
RESEARCH DESIGN AND METHODS .....................................................................22
PARTICIPANTS AND RECRUITMENT PROCEDURE ...............................................22
MEASURES ..................................................................................... 23
STATISTICAL ANALYSES........................................................................................27
RESULTS ..................................................................................... 29
DEMOGRAPHICS ...............................................................................29
CORRELATIONS ................................................................................29
CONTEXTUAL EFFECTS ON EAH.........................................................................30
Direct effect of EAH on BMI................................................................................30
Indirect effect of parent feeding practices in the relationship between parenting and EAH................31
Direct effect of higher perceived stress on EAH..................................................31
Moderation of the perceived stress effect by stress coping................................31
POST HOC ANALYSES ..................................................................... 32
DISCUSSION .............................................................................. 33
EATING IN THE ABSENCE OF HUNGER AND BODY MASS INDEX.....................34
AUTHORITARIAN PARENTING, PARENT FEEDING, AND EATING IN THE ABSENCE OF HUNGER..................34
PERCEIVED STRESS, COPING, AND EATING IN THE ABSENCE OF HUNGER ...............................................38
RELEVANCE OF TREATMENT SEEKING SAMPLE AND IMPORTANCE OF TREATMENT RETENTION..............40
ADJUNCT TREATMENT MODALITIES .........................................42
STRENGTHS AND LIMITATIONS ................................................... 44
FUTURE DIRECTIONS .................................................................. 44
CONCLUSION......................................................................... 46
TABLES AND FIGURES ........................................................47
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