Comfort eating in the Eating in America Study: New insights to inform prevention and intervention efforts across the lifespan

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About 35% of U.S. adults engage in comfort eating, defined as increasing one’s food intake or eating high- calorie/fat/sugar foods in response to stress or other negative emotions. Comfort eating predicts subsequent weight gain and also mediates links between stress and depressive symptoms with Body Mass Index (BMI). Beyond effects on BMI, many unhealthy comfort foods are ultra-processed foods high in saturated fat, sugar, and salt—foods that heighten risk of developing type 2 diabetes. Moreover, experiments manipulating comfort eating do not evidence any meaningful causal benefits of this behavior for psychophysiological stress responses. These adverse characteristics of comfort eating have motivated interventions; however, efforts to curb comfort eating have neglected to attempt to prevent its initial development in early life—an approach that could minimize negative health impacts across the lifespan. Furthermore, intervention reviews have concluded that resulting effect sizes are often small (e.g., Cohen’s d = 0.12 to 0.26) or inconsistent (Cohen’s d = -0.17 to 0.04), and scholars have called for additional research to determine which intervention methods are most appropriate for which individuals. Relatedly, although self-efficacy—how confident people are that they can perform a certain behavior—is a robust predictor of both behavioral intentions and actual behavior in other literatures, little is known about which factors are associated with self-efficacy for comfort eating cessation. To address these critical gaps in knowledge, we will analyze data from the Eating in America Study collected from December 2019 to January 2020 among a national census-matched sample of 2,022 U.S. adults age 18 and older, carrying out the following specific aims: 1) Characterize the etiology of comfort eating from a life course perspective using a mixed-methods approach; 2) Identify demographic, comfort food, belief, developmental, and psychosocial factors associated with self-efficacy to quit comfort eating; and 3) Determine which sub- populations may be at elevated risk for poor health outcomes associated with comfort eating. This research will generate new knowledge regarding how stages in the lifespan, life events, and the familial environment may play a role in the origins of comfort eating. Furthermore, this project will be the first in a large, national sample to examine self-efficacy to quit comfort eating and the key factors that explain it—data that could reveal new levers for influencing this key construct and thereby, comfort eating itself. Finally, this investigation will provide new insights into which sub-populations may be at greater risk of the poor health that comes with comfort eating. Equipped with these novel insights generated with support from the NIDDK (PAR-21-313), in the next stage of her transition to research independence, the PI (Dr. Finch) will move forward with her long-term goal of developing and testing a new generation of targeted, tailored, and innovative comfort eating prevention and intervention techniques. For instance, novel techniques may include prevention in childhood or adolescence by targeting parental behaviors, and/or changing beliefs about comforting capacities of comfort eating.