PROJECT SUMMARY/ABSTRACT
Weight bias internalization (WBI), or self-directed weight-based stigma, has been associated with a number of
negative physical and mental health consequences for adolescents with obesity, including negative weight-
related outcomes (e.g., increased calorie consumption, poorer weight loss outcomes). The prevalence and
salience of WBI as a stressor impacting weight-related outcomes in adolescents paired with the heterogeneous
response to interventions for adolescents with obesity highlights the potential utility of combined intervention for
WBI and obesity in youth to promote improved weight management outcomes during this critical developmental
period. This K23 award is designed to fill gaps in my training and support a research study that will provide next
steps in improving the health of adolescents with obesity. The first phase of the research project will employ
focus groups and an open pilot trial to develop and test feasibility of an integrated intervention that combines
treatment for WBI with an evidence-based adolescent behavioral weight control (BWC). I will then conduct a
small RCT to test the effects of the newly designed WBI+BWC intervention on WBI and mechanisms of weight-
stigma stress induced weight gain, specifically physiological markers of stress (diurnal cortisol) and inflammation
(c-reactive protein, interleukin-6), and dysregulated eating behaviors (emotional eating, loss of control, unhealthy
weight control behaviors). I hypothesize that BWC combined with intervention for WBI, will lead to improvements
in mechanisms of weight-stigma stress induced weight gain, in turn promoting improved weight loss outcomes.
This research project has significant clinical implications for the improvement of adolescent BWC and reduction
of the negative effects of weight-based stigma in adolescents. To conduct this research and fill critical gaps in
my training that will facilitate becoming an independent investigator focused on behavioral treatment of obesity
in adolescents, I will complete a rigorous, targeted training program. The proposed training plan includes
developing expertise in 1) conducting RCTs to develop and test BWC interventions for adolescents; 2) theoretical
and conceptual models of weight-based stigma and WBI; 3) integration of mechanisms in clinical trials focused
on biological markers and dysregulated eating behaviors; and 4) professional development. This training will be
conducted under the primary mentorship of Dr. Elissa Jelalian, with co-mentors Drs. Rebecca Puhl, Stephanie
Parade, Andrea Goldschmidt, and contributor Dr. David Barker. The skills I will acquire map directly onto the
proposed research project and provide the knowledge and expertise necessary to prepare a successful R01
application by the end of the award period. The mentorship team, in combination with the rigorous academic and
training environment provided by the Weight Control and Diabetes Research Center at The Miriam Hospital and
Brown University, represent an ideal environment to accomplish these training and research goals. Through this
Career Development Award, I will establish myself as an independent investigator dedicated to the development
of novel interventions to improve health outcomes for adolescents with obesity.