How social relationships influence even “small” eating behavior changes: Low‐income urban adults’ experiences in a pilot weight loss intervention

Abstract

Small eating behavior changes (SEBCs) are proposed as more feasible to make & sustain than larger changes typical of traditional behavioral weight loss interventions. This qualitative analysis focuses on how the social environment impacts the experience of SEBC in a 12 week pilot weight loss intervention. Interviews with 46 men & women (mean age 51, mean initial BMI 34kg/m2, 56% Black, 41% Hispanic) investigated challenges, facilitators, & the role of social interactions in making one participant‐selected SEBC. Verbatim transcripts were analyzed using the constant comparative method. Emergent themes included work & family demands, food roles & responsibilities, home food environment, & network responses to intervention involvement acting as both barriers & facilitators. Participants also discussed strategies used to negotiate SEBCs in the social environment & navigate challenges, including selective disclosure of intervention involvement, integrating SEBCs into social settings, & asserting food control. Gender differences were reported: men were less likely to report family influence & more likely to report strategies to navigate their social environment. Small EBC interventions should (1) consider the impact of the social environment & (2) help participants develop strategies to identify & navigate social barriers to EBC.Grant Funding Source: NHLBI, USDA Ecology of Obesity Training Grant