Stressful Life Events and Behavior Change: A Qualitative Examination of African American Women's Participation in a Weight Loss Program

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Stressful events occur in routine life and demand a certain amount of attention, time, and effort. How one copes with stressful events may vary based on a variety of factors including age, gender, socioeconomic status, and race (Tanyi & Werner, 2007). Coping skills may also vary based on the perceived severity of the stress, the resources available to deal with the stressful event, and the perceived relative importance of other commitments (Ark, Hull, Husaini, & Craun, 2006; Cuellar, 2002; Culver, Arena, Antoni, & Carver, 2002; Haley et al., 1996). During a stressful event, coping skills to manage perceived demands may dictate to some degree how an individual prioritizes other commitments.

The apparent impact of stress on weight-related behaviors, such as dietary intake and physical activity habits can be magnified in the context of trying to change these behaviors. Changing weight-related behaviors in an attempt to lose weight or improve health requires considerable effort to alter established habits. This effort can be affected by stressful events, either by affecting mental focus devoted to behavior change or by serving as a stimulus for resuming old habits (e.g., eating when stressed). During stressful life events, maladaptive coping skills may result in behaviors that lead to decreased well-being. For example, Freeman and Gil (2004) found a significant relationship between both depressed affect and psychological stress and increased incidence of same-day binge eating behaviors among a population of females who had a history of binge eating behaviors. Henderson and Huon (2002) found a comparable relationship among a sample of overweight women. Similarly, women report that stress affects their eating patterns by causing erratic eating schedules or practices that lead to mindless eating such as multitasking while eating (Devine et al., 2006). Stress has also been linked to lower physical activity levels. Perceived barriers such as a lack of time and a lack of social support have been shown to have a direct effect on exercise by preventing adoption of new exercise behavior or decreasing existing behavior patterns (Ainsworth, Wilcox, Thompson, Richter, & Henderson, 2003; Nies, Vollman, & Cook, 1999).

African American women have been shown to have unique responses to stressors and a unique complement of coping strategies (Cuellar, 2002; Haley et al., 1996). The unique coping strategies may be a result of a variety of social circumstances (e.g., single mother head of household, caring for multiple generations, discrimination) that promote change and variability in daily routines, thereby dictating the need to be adaptable. Given that African American women have the highest prevalence of overweight and obesity among any major ethnic/gender subgroup in the U.S., one might propose that overeating is a coping strategy employed by African American women to deal with daily stressors. Though there are certainly other documented explanations that attempt to address the obesity disparity seen in African American women, this abnormal coping strategy of emotional and stress-related eating may also account for some degree of this disparity.

The stress resulting from social circumstances faced by many African American women is often compounded by occupational stress. The total number of work hours has increased in recent years among single parents, racial minorities, and low-income positions, all of which characterize African American women to some extent (Jacobs & Gerson, 2001). According to annual averages of employment status reported by the U.S. Department of Labor (2004), a larger proportion of African American women aged 16 and older are employed compared with White, Asian, or Hispanic women. This increase in workload and work-related stress can often spill over to family roles and increase the stress already associated with fulfilling familial responsibilities (Devine et al., 2006). …