Examination of the Interpersonal Model With Adolescent Military Dependents at High Risk for Adult Obesity
Publication: American Journal of Psychotherapy
Abstract
Objective:
Adolescent military dependents may be at higher risk for psychosocial stressors and disordered eating compared with civilian youths, but the mechanisms underlying these risks are unclear. Interpersonal theory proposes that difficult relationships lead to negative affect, thereby promoting emotional eating, which has been linked to and predictive of disordered eating. The interpersonal model may have particular relevance for understanding disordered eating among adolescent military dependents, given the unique stressors related to their parents’ careers. This study aimed to examine the premise of the interpersonal model (that negative emotions mediate the association between multiple aspects of social functioning and emotional eating) among a cohort of adolescent military dependents.
Methods:
Military dependents (N=136; 56% female, mean±SD age=14±2 years, body mass index adjusted for age and sex [BMIz]=2.0±0.4) at risk for adult obesity and binge eating disorder, as indicated by reported loss-of-control eating and/or anxiety symptoms, were assessed prior to participation in a study of excess weight-gain prevention. Bootstrapped mediation analyses 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-ethnicity, BMIz, and 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 loneliness, social adjustment related to family and friends, attachment to father and peers, and emotional eating (p<0.05).
Conclusions:
The interpersonal model may contribute to our understanding 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 treatment response and outcomes among this population.
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History
Received: 29 July 2019
Revision received: 19 October 2019
Revision received: 10 December 2019
Accepted: 20 December 2019
Published online: 13 February 2020
Published in print: June 01, 2020
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Competing Interests
Dr. Wilfley has received an honorarium from the Center for Children’s Healthy Lifestyles and Nutrition, consulting fees from Sunovion Pharmaceutical and Weight Watchers, and grant support from the Health Care Foundation of Greater Kansas City and the Patient-Centered Outcomes Research Institute. Dr. Yanovski has received grant support from Soleno Therapeutics and Rhythm Pharmaceuticals. The other authors report no financial relationships with commercial interests.
Funding Information
This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (1-R01-DK-104115-01 to Dr. Tanofsky-Kraff), the Defense Health Agency (MED-83-10180), and the Intramural Research Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development (ZIA-HD-00641 to Dr. Yanovski). ClinicalTrials.gov identifier: NCT02671292.The funding sources had no involvement in the study design; collection, analysis, and interpretation of the data; writing of the report; or decision to submit the article for publication. Mr. Leu, Dr. Yanovski, Dr. Klein, and Dr. Quinlan are commissioned officers in the United States Air Force, Navy, or Public Health Service (PHS). The opinions and assertions expressed herein are those of the authors and do not necessarily reflect the views of the Air Force, Navy, PHS, Uniformed Services University of the Health Sciences, Fort Belvoir Community Hospital, or the U.S. Department of Defense.
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