"I Wish I Never Got on That Roller Coaster": A Qualitative Investigation of the Emotional Antecedents and Correlates of Loss of Control Eating in Black Youth Living in Larger Bodies.

OBJECTIVE

Loss of control (LOC) eating is common among adolescents and is linked to adverse physical and psychosocial outcomes. Black youth report equal or higher rates of LOC than white youth, yet little research has examined culturally specific factors underlying these experiences. Prior findings on emotional precursors to LOC in Black adolescents are mixed, highlighting the need for foundational qualitative work. This study explored how Black teens understand, experience, and interpret LOC eating.

METHOD: Twenty-one Black adolescent girls participated in six virtual focus groups (n = 3-4 participants each), and seven Black adolescent boys completed individual Zoom interviews. All were ages 14-17, had overweight or obesity, and reported LOC eating within the past 3 months. Sessions explored the emotional and contextual factors surrounding LOC episodes. Using applied thematic analysis, transcripts were double coded with a collaboratively developed codebook, and data collection continued until thematic saturation was achieved.

RESULTS

Girls described three emotional pathways to LOC: (1) eating in response to a high-arousal, negatively-valenced state (e.g., anxiety), (2) eating in response to a low-arousal, negatively-valenced state (e.g., boredom), and (3) eating in response to a high-arousal, positively-valenced state (e.g., joy) that devolves into LOC. Boys endorsed Pathways 1 and 2 but less often Pathway 3, instead describing difficulty identifying and articulating the emotional antecedents of LOC, as well as experiences of teasing or critical family comments as key triggers for these episodes. Participants often recognized upon reflection that LOC episodes were emotionally driven and later experienced regret.

DISCUSSION: Findings highlight multiple emotional and contextual pathways to LOC and underscore the role of regret, family expectations, and cultural norms, emphasizing the importance of culturally and developmentally appropriate intervention approaches.