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<p>Research using self-report or explicit measures of body image suggests African American women have a more accepting view of larger figures than non-Hispanic White (NHW) women. However, increasing research indicates that explicit views may vary from those held at a deeper, implicit level.</p><p>Our study examined whether African American women held an implicit negative bias toward overweight/fat individuals, despite a greater explicit acceptance of larger body size. Additionally, ethnic identity was measured to assess if strength of identity relates to bias. Anti-fat bias was compared within and between ethnic groups using an Implicit Association Test (IAT), which measures the strength of automatic associations between two concepts. This online IAT measured spontaneous thoughts about figures of various body weights (underweight, overweight, obese) and positive and negative terms (eg, attractive and unattractive or healthy and unhealthy). </p><p>A pervasive anti-fat bias was found in African American as well as NHW women. For both groups this bias was related to ethnic identity when thinking about figure size and health. Specifically, African American women with lower ethnic identity were more negatively biased and NHW women with higher ethnic identity were more negatively biased. </p><p>Findings from this study indicate that implicitly there are few differences in the way these two ethnicities classify heavy figures, and therefore African Americans may not be immune to weight stigma. Given the prevalence of obesity and the lack of research on weight stigma among African American women, there is need to address this issue and its impact on well-being. <em>Ethn Dis.</em> 2016;26(1):69-76; doi:10.18865/ed.26.1.69</p>

The more consistently someone records their food intake the more likely they are to lose weight. We hypothesized that subjects who kept track via their preferred method would demonstrate higher adherence and therefore improved outcomes compared to those who used a non-preferred method. Participants were randomly assigned to use a paper, PDA, or Web-based diary and classified as "Preferred" if they used their preferred method and "Non-Preferred" if they did not. Days adherent to diary use were collected for 12 weeks. Weight, % body fat, waist circumference, and self-efficacy scores were measured at baseline, 6 and 12 weeks. Thirty nine participants completed the 12 week study. Fifty nine percent were male. The mean age was 35 and mean baseline BMI was 33 kg/m2 (±3.5). Forty four % (n=17) used their "Preferred" diary method and 56% (n=22) did not. Participants who used their preferred diary were more adherent to recording both food intake (64.2% vs. 43.4%, p=.015) and exercise (60.6% vs. 31.2%, p=.001). Though no difference was seen between groups on weight management outcomes, these results suggest that diary preference affects adherence to diary use.

The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Uniformed Services University of the Health Sciences, Department of the Navy, Department of Defense or the U. S. government.

Background: Among adults, weight stigma is associated with markers of poor cardiometabolic health. Although weight-based teasing (WBT) is common among youth with high body weight, few studies have examined its associations with cardiometabolic markers. Owing to unique stressors (e.g., parental deployment and frequent moves), military-dependent youth may be at particularly high risk for obesity, WBT, and poor cardiometabolic health. We, therefore, assessed associations between WBT and cardiometabolic health markers among adolescent military dependents presenting for a weight gain prevention trial. Methods: Participants underwent fasting phlebotomy; had fasting weight, height, and waist circumference measured; and completed assessments of WBT, anxiety, and loss-of-control eating. Multivariate analysis of covariance, adjusting for relevant covariates including demographics and body composition, was used to examine differences in metabolic syndrome (MetS) components (waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose) between youth reporting WBT and youth reporting no WBT. Bootstrapped models examined whether WBT mediated the relationship between BMIz and MetS components. Results: Data from 142 youth (57.7% female; 14.4 ± 1.6 years; 51.2% non-Hispanic White, 20.9% non-Hispanic Black; BMIz: 1.9 ± 0.4) were analyzed. WBT was not significantly associated with any MetS component. Relationships were observed between BMIz and all MetS components (except systolic blood pressure and glucose), although WBT did not significantly mediate these relationships (p's > 0.05). Conclusions: This study did not find support for a relationship between WBT and MetS components in adolescent military dependents at risk for adult obesity. Prospective research is needed to determine whether associations between WBT and adverse cardiometabolic outcomes emerge primarily in adulthood.

OBJECTIVE: Adolescent military-dependents may be at higher risk for psychosocial stressors and disordered-eating compared to civilian youths, but the mechanisms underlying these relationships are unclear. Interpersonal theory of disordered-eating proposes that difficult relationships lead to negative affect thereby promoting emotionally-induced eating. Given the unique stressors related to their parents' careers, the interpersonal model may be particularly relevant to adolescent military-dependents. Therefore, this study examined the prediction of the interpersonal model (that negative emotions mediate the link between multiple aspects of social functioning and emotional-eating) among a cohort of adolescent military-dependents. METHODS: One-hundred-thirty-six military-dependents at high-risk for both adult obesity and binge-eating disorder due to reports of loss-of-control eating and/or anxiety symptoms (56% female, age=14±2y, BMIz=2.0±.4) were studied prior to participation in an excess weight-gain prevention study. Bootstrapping mediation models were conducted to examine depressive symptoms as a potential mediator of the relationship between social functioning and emotional-eating. Analyses were adjusted for age, sex, race, BMIz, the presence of reported loss-of-control eating, and anxiety. RESULTS: Depressive symptoms were a significant mediator of the relationship between multiple domains of social functioning, including general social loneliness, social adjustment related to family and friends, and attachment to father and peers, and emotional-eating (ps < .05). CONCLUSIONS: The interpersonal model of disordered-eating may be important for understanding the development of excess weight-gain and binge-eating disorder among adolescent military-dependents. Prospective data are needed to determine the utility of interpersonal theory in predicting response to intervention and outcomes.

BACKGROUND: Metabolic syndrome in adolescence has been associated with adverse cardiometabolic outcomes in adulthood. Preliminary data suggest that boys may have worsened metabolic syndrome components compared to girls. Yet, little is known about the physical health of military dependents, a potentially at-risk population. OBJECTIVE: Examine sex differences in metabolic syndrome components in a sample of adolescent military dependents. METHODS: Participants were adolescents (N = 139; 14.4 ± 1.6 years; 45.3% male; 41.0% non-Hispanic White, 19.4% non-Hispanic Black; BMI-z: 1.9 ± 0.4) at-risk for adult obesity and binge-eating disorder due to an age- and sex-adjusted BMI ≥85th percentile and loss-of-control eating and/or elevated anxiety. A multivariate analysis of covariance was conducted to compare objectively measured metabolic syndrome components across boys and girls. Covariates were age, race, loss-of-control eating status, anxiety symptoms, and BMI-z. RESULTS: Metabolic syndrome components differed by sex (P = .01). Boys had higher systolic blood pressure (P = .049), lower high-density lipoprotein cholesterol (P = .01), and higher glucose (P = .001) than girls. Waist circumference, diastolic blood pressure, and triglycerides did not differ between boys and girls (P > .05). CONCLUSIONS: Future research should prospectively examine these relationships into adulthood. If the current findings are supported, prevention programs should consider targeting cardiometabolic health particularly among male adolescent military dependents.

OBJECTIVE: Parental military deployment can lead to stress in the family system due to concerns about the deployed service-member's safety and increased responsibilities for those not deployed. Parent-related stress can impact adolescent disordered eating. Given the important role that stress plays in disordered eating and obesity, it is crucial to understand the impacts of unique stressors to which vulnerable populations are exposed. METHOD: We studied 126 adolescent (14.3 ± 1.6y; 59.5% girls; 44.4% Non-Hispanic White; BMI-z, 1.91 ± .39) military dependents prior to entering an obesity and binge-eating disorder prevention trial. The Eating Disorder Examination was used to assess adolescent disordered eating. Parents self-reported their own distress and family deployment history that occurred during the adolescent's lifetime. RESULTS: Parental distress interacted with frequency of parental deployments such that for those with high parental distress, more frequent deployment was associated with greater adolescent shape and weight concerns (β = .21, p = .012) and global eating pathology (β = .18, p = .024). DISCUSSION: In this hypothesis-generating study, the combination of number of deployments and parental distress may be associated with disordered eating among adolescent military dependents seeking prevention of binge-eating disorder and adult obesity. If these preliminary findings are supported longitudinally, interventions to reduce parental stress related to deployment may be warranted to reduce disordered eating in adolescent dependents.

Obesity impacts the U.S. military by affecting the health and readiness of active duty service members and their families. Preventing Obesity in Military Communities (POMC) is a comprehensive research program within Patient Centered Medical Homes (PCMHs) in three Military Training Facilities. This paper describes three pilot randomized controlled trials that target critical high risk periods for unhealthy weight gain from birth to young adulthood: (1) pregnancy and early infancy (POMC-Mother-Baby), (2) adolescence (POMC-Adolescent), and (3) the first tour of duty after boot camp (POMC-Early Career). Each study employs a two-group randomized treatment or prevention program with follow up. POMC offers a unique opportunity to bring together research and clinical expertise in obesity prevention to develop state-of-the-art programs within PCMHs in Military Training Facilities. This research builds on existing infrastructure that is expected to have immediate clinical benefits to DoD and far-reaching potential for ongoing collaborative work. POMC may offer an economical approach for widespread obesity prevention, from conception to young adulthood, in the U.S. military as well as in civilian communities.