Currently, 78 million U.S. adults are obese and little progress has been made in reducing the number of individuals with this complex problem. The most serious consequences of obesity are metabolic abnormalities, which are the major predictors of coronary heart disease, stroke, and type 2 diabetes. It is crucial for the well being of individuals and society to develop effective interventions, but this can only be done once specific intervention targets are identified. To that end, the purpose of this fellowship applicatin is to provide vital training experiences so that the candidate can develop the knowledge and skills necessary to become a strong nurse researcher with considerable and growing expertise in obesity, binge eating, structural equation modeling, and biobehavioral research. This foundation is necessary to accomplish the candidate's long-term career objective of becoming an independent and productive nurse scientist who contributes solutions to the obesity epidemic. As part of the training plan, the candidate will conduct a secondary data analysis to examine the biobehavioral pathways linking stress to metabolic abnormalities-a well-recognized link, but with mechanisms that are unclear. One mechanism that would account for how and why the relationship between stress and metabolic abnormalities occurs is binge eating. Though there is strong theoretical support for the idea that binge eating mediates the relationship between stress and metabolic abnormalities, empirical testing is necessary. Thus, the specific aims of this study are to: 1) Identify the relationships among self-reports of stress (early trauma and chronic, recent, and perceived stress), binge eating, and metabolic abnormalities in adults, 2) identify the relationships among self-reports of stress, the cortisol awakening response, binge eating, and metabolic abnormalities in adults;and 3) explore moderators (age, gender, and socioeconomic status) of these relationships. This study will use data collected from the Interdisciplinary Research Consortium on Stress, Self-Control, and Addiction (PL1-DA024859 and UL1- DE019859), and will be analyzed using structural equation modeling. The candidate will also participate in a unique combination of coursework, research, and teaching experiences to help her achieve her training goals. This proposal addresses the National Institute of Nursing Research's mission of enhancing health promotion and disease prevention, as the knowledge gained from this study will provide specific targets for preventative and therapeutic obesity interventions. Furthermore, this study will serve as the first step in a broader research program to more fully understand the complexities of binge eating and obesity, and to develop interventions to prevent and treat binge eating and obesity in people of all ages.
Despite recent attention, obesity still poses a serious threat to society and continues to result in countless health, psychosocial, and financial consequences. Given that metabolic abnormalities such as high abdominal fat, high triglycerides, and insulin resistance are some of the most harmful obesity-related outcomes, the proposed study will identify whether binge eating is a mechanism that links stress to these metabolic abnormalities. This study will clarify biobehavioral processes contributing to the obesity epidemic, which will help to identify additional and more specific targets to increase the effectiveness of obesity prevention and treatment strategies.
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