Background Although studies have traced the impact of COVID-19 on those with eating disorders, little is known about the specific impact of the pandemic on Black American women who report disordered eating behaviors and are at risk for eating disorders. Thus, the purpose of this study is to investigate the impact of COVID-19 on Black women who binge-eat. Methods We recruited a purposive sample during the first wave of COVID-19 from the southeastern United States. Participants identified as Black women, reported binge-eating episodes in the last 28 days, and agreed to participate in a semi-structured interview. Prior to the interview, participants were administered a socio-demographic survey and the Eating Disorder Examination-Questionnaire. Interviews were transcribed verbatim and analyzed independently using qualitative content analysis and open coding to identify relevant codes and themes. Results On average, participants ( N = 20) were 43.05 ± 16.2 years of age and reported 5.6 ± 5.7 binge-eating episodes in the last 28 days. We identified six themes to describe participants' experiences managing their eating behavior during COVID-19: (1) food as a coping strategy; (2) lack of control around food; (3) increased time in a triggering environment (e.g., being at home with an easy availability of food); (4) lack of structure and routine; (5) challenges with limited food availability; and (6) positive impact of the pandemic. Conclusion In this study, Black women reported challenges managing their eating behavior during COVID-19. Results could inform the development and tailoring of treatments for Black women reporting disordered eating behaviors. Level of Evidence Level V, qualitative interviews.

Objective: The COVID-19 pandemic created significant challenges in accessing and receiving treatment for individuals with eating disorders (EDs). The purpose of this study is to explore perceptions of and experiences with ED treatment during the first year of the pandemic among individuals with past and self-reported EDs in the United States. Methods: Online surveys were administered to adults (N = 510) with a past or current self-reported ED at 13 timepoints between April 2020 and May 2021. Using longitudinal qualitative analysis, 5651 free-text responses were examined to capture experiences with ED treatment and generate inferences of change over time. Results: We categorized results into four sequential, temporal quarters and identified patterns that explained participants' perceptions of facilitators, barriers, and experiences with ED treatment over time: Quarter 1. Treatment Disruption and Reorienting Recovery; Quarter 2. Accumulating COVID-19 Stress and Virtual Treatment Woes; Quarter 3. A Continuation of Inadequate Care; and Quarter 4. Ongoing Adaptation and Adjustment to Uncertainty. Participant experiences were marked by numerous barriers to accessing care, challenges adjusting to virtual treatment, unmet treatment needs, and beginning acceptance of telehealth.Discussion: Our findings present a timeline to help evaluate challenges related to navigating the switch to virtual care which created significant disruption to ED recovery. Participants spent much of the first year trying to adjust to unemployment, loss

Background Obesity is an established risk factor for post-menopausal triple negative breast cancer (TNBC). Multiple aspects of fatty acid metabolism, including fatty acid synthesis, are upregulated in white adipose tissue during obesity development. The enzyme pyruvate carboxylase (PC), a supportive player in fatty acid synthesis, is relied upon for metastasis of murine TNBC particularly in models of obesity- further elucidating the importance of fatty acid metabolism to breast cancer progression in those with obesity. Ferroptosis, a method of cell death induced by peroxidation of phospholipid fatty acyl chains, is a recently discovered and rapidly developing mechanistic target in multiple cancer types. While several cancers, including breast cancer, are sensitive to ferroptosis induced by different mechanisms, the metabolic vulnerabilities and consequent therapeutic potential of ferroptosis are just beginning to be explored. This study aims to determine whether obesity-driven reprogramming of fatty acid metabolism exacerbates breast cancer progression via altered sensitivity to ferroptosis Methods The relationship between obesity, breast cancer and lipid peroxidation was investigated in vitro via proliferation assays, qPCR, Western blot and flow cytometry using multiple murine models of breast cancer treated with erastin and RSL3. PC was suppressed using shRNA introduced via lentiviral transduction. In vivo tumor growth in lean and obese mice was determined following treatment with erastin, RSL3, or a vehicle control. Results In vitro data reveals that TNBC cells are highly sensitive to treatment with the ferroptosis-inducing molecules erastin and RSL3. Erastin treatment transcriptionally induces PC expression in several murine models of TNBC in vitro. Suppression of PC at baseline (without ferroptosis induction) is sufficient to induce transcription of glutathione peroxidase-4 (a critical regulator of ferroptosis). While Affymetrix array data of untreated metastatic M-WntLung primary tumors showed a decrease in PC and associated genes in tumors from obese mice relative to lean mice, treatment with erastin increased PC expression specifically in tumors from obese mice. Tumors from obese mice relative to control mice have an altered response to treatment with the ferroptosis inducing molecules erastin and RSL3. Conclusion These data indicate that obesity-associated dysregulation of lipid metabolism and regulation of PC may be key determinants of sensitivity to induction of ferroptosis. Future work will delineate the relationship between breast cancer, ferroptosis, and fatty acid metabolism utilizing in vivo models to determine whether ferroptosis-specific mechanisms are exacerbated with PC suppression to further impede obesity-exacerbated tumor growth. Citation Format: Emily Devericks, Michael F. Coleman, Hannah Malian, Violet Kiesel, Dorothy Teegarden, Stephen D. Hursting. Metabolic links between obesity and ferroptosis in a murine model of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1627.

SummaryDespite the availability of evidence‐based interventions to improve binge eating, Black women have some of the lowest rates of access to care for eating disorders. Innovation is needed to offer accessible and culturally relevant treatment options. To this end, using an open trial design, we investigated the feasibility and acceptability of a group‐based, appetite awareness training (AAT) + lifestyle modification (LM) programme in Black women at risk for BED in a primary care setting. Participants (n = 20) were Black women recruited from a family medicine centre affiliated with a local public university, and who reported at least two binge eating episodes in the last 28 days. Participants completed a 16‐session AAT + LM programme over 4 months. Key outcomes were objective binge eating (assessed by the EDE and the EDE‐Q), body dissatisfaction, and weight change, all assessed at baseline, four (post‐treatment) and 6 months (2‐month follow‐up). Ninety‐five percent of participants completed assessments at post‐treatment and attended nearly 60% of intervention sessions. Among completers (n = 19), body dissatisfaction and objective binge eating decreased from baseline to post‐treatment and this decrease was maintained at the 2‐month follow‐up. In exit interviews, participants reported programme satisfaction. Providing training in appetite awareness combined with lifestyle modification principles may be useful in the treatment of body dissatisfaction and binge eating among Black women.