Social undermining of weight management behaviors among young adult African American women: an ecological momentary assessment and mixed-method study

Background: Social undermining of weight management behaviors represents a meaningful intervention target as social undermining may lead to dietary and exercise lapses. Young adult African American women, who exhibit the highest prevalence of obesity compared to young adults of all other races and ethnicities, may experience different types of social undermining or respond differently to social undermining due to various cultural factors (eg, cultural value of traditional foods). Purpose: This study characterizes the sources and settings of weight management social undermining experiences of young adult African American women. Methods: Young adult African American women who were attempting to lose weight or prevent weight gain were recruited. Participants completed 2 weeks of ecological momentary assessment (EMA) surveys sent 5 times daily related to social undermining experiences. Participants were asked to describe the source and setting of social undermining experiences. Qualitative interviews were conducted following the EMA period to further characterize reported social undermining. Results: Participants (n= 36) were 21.8 ± 1.7 years of age with a body mass index of 33.8 ± 7.4 kg/m². On average, participants experienced 2.3 social undermining experiences per week (range: 0-7). Most social undermining was diet-related (79.3%) and perceived by participants as not culturally relevant (85.2%). Most social undermining happened at home (31.4%) and came from friends (31.4%). Qualitative interviews revealed that social undermining often occurred during culturally specific social gatherings and was related to cultural perspectives on body weight. Conclusion: These results can aid in the development of relevant and acceptable strategies for responding to social undermining within young adult African American women.