The Impact of Negative Familial Weight Talk on Weight Bias Internalization and Preliminary Efficacy of Intervention in Early Adolescents

PROJECT SUMMARY Weight stigma undermines the health and quality of life of early adolescents. Negative familial weight talk, which refers to weight teasing and critical comments about weight from family members, is a significant contributor to adolescent weight stigma. An unexplored consequence of negative familial weight talk in early adolescents is

weight bias internalization (WBI), a type of self-directed stigma associated with body dissatisfaction, poor self- esteem, and unhealthy weight control behaviors. Given these serious consequences, it is critical to elucidate the determinants of WBI, especially during early stages of development. Moreover, no intervention, to the best of

our knowledge, has been designed to reduce the occurrence of negative weight talk within the context of the family environment. The proposed research seeks to expand our understanding of negative familial weight talk and examine the preliminary efficacy of an innovative intervention designed to reduce negative familial weight

talk. Furthermore, as a brief, universal prevention intervention, the approach holds promise for significant public health impact because it is resource efficient, a critical characteristic for future adoption and dissemination. The specific research aims are: to evaluate the association between negative familial weight talk and WBI in a diverse

cohort of early adolescents, 5th-7th graders, (Aim 1), to implement and examine the preliminary efficacy of a brief, universal prevention intervention on the frequency of negative familial weight talk from the participant parent (Aim 2), and improvements in the content of parent-child conversations about weight (Aim 3). All research aims

will be addressed using data from the SUPPER Project (R01 DA045073), an ongoing universal prevention intervention for parents of early adolescents in the Greater Boston Area. SUPPER is a randomized-control trial with clustering wherein the intervention group focuses on substance use and the comparison group on negative

familial weight talk. For the proposed research, the negative familial weight talk condition serves as the treatment group. Baseline questionnaire data will be used to cross-sectionally examine the association between negative familial weight talk from all family members and WBI in early adolescents (Aim 1). Questionnaire data and audio-

recorded parent-child conversation at baseline, 3-, and 6-months post-randomization will respectively be used to examine the effect of the intervention on the frequency of negative familial weight talk (Aim 2) and improvements in parent-child conversations about weight (Aim 3). This research addresses an important gap in

expanding our understanding of WBI in youth. If effective, the intervention has the potential to reduce adolescent weight stigma and may prevent associated adverse outcomes and support the long-term well-being of youth. The goals of the fellowship training plan are to provide mentorship and practical training in 1) weight stigma and

WBI, 2) advanced statistical methods, 3) study design, implementation, and operations, and 4) provide opportunities to build competencies central to long-term career goals. Training will be provided by a Sponsor Team lead by Dr. Must (Primary Sponsor) at Tufts University School of Medicine and Friedman School of

Nutrition Science and Policy.