# Binge Eating as a Mechanism Underlying the Food Insecurity-Obesity Paradox in Adolescents

> **NIH NIH R00** · HENRY FORD HEALTH + MICHIGAN STATE UNIVERSITY HEALTH SCIENCES · 2024 · $249,000

## Abstract

PROJECT SUMMARY/ABSTRACT 
Food insecurity is paradoxically associated with elevated risk of adolescent obesity in the United States. The 
mechanisms underlying this excess risk are not well understood, and such knowledge is essential for informing 
obesity prevention efforts for adolescents from under-resourced backgrounds. Thus, aligned with the need 
emphasized by the Strategic Plan for NIH Obesity Research to identify the reasons contributing to increased risk 
for obesity among economically marginalized populations, research is critically needed to elucidate modifiable 
mechanisms to target in obesity prevention efforts among food-insecure adolescents. In the proposed project, 
Dr. Hazzard, a registered dietitian and public health researcher, will examine binge eating as a potential 
mechanism to explain the association between food insecurity and elevated risk for adolescent obesity. The K99 
phase of this Pathway to Independence Award supported Dr. Hazzard in filling critical training gaps and 
conducting the research necessary to launch her career as an independent investigator conducting intervention 
work to promote food security and healthy weight among adolescents experiencing food insecurity. Through 
coursework, mentorship, and research, Dr. Hazzard gained expertise in (1) qualitative and mixed methods, (2) 
advanced statistical methods, with a focus on machine learning and causal mediation analysis, and (3) 
intervention design, development, and dissemination, with an emphasis on human-centered design. During the 
mentored K99 phase, she worked to elucidate the etiology of binge eating in the context of food insecurity during 
adolescence using a mixed-methods approach that involved (a) conducting qualitative interviews in foodinsecure adolescents who report binge eating and (b) leveraging existing data from an NIH-funded observational 
cohort to employ tree-based machine learning techniques. In the independent R00 phase, Dr. Hazzard will recruit 
175 adolescents into a new, independent cohort that she will follow for 18 months to quantify the extent to which 
binge eating mediates the longitudinal association between food insecurity and weight gain during adolescence 
(Aim 1 of the R00 phase). Finally, using a human-centered design approach, she will develop vignettes 
describing potential interventions in community settings to improve food security and prevent excess weight gain 
among food-insecure adolescents and assess perceived acceptability of the potential interventions using these 
vignettes in semi-structured interviews with adolescents who have experienced food insecurity (Aim 2 of the R00 
phase). Findings from this project will lay the groundwork for the development and implementation of an 
intervention in a community setting to promote food security and healthy weight among adolescents experiencing 
food insecurity and, in turn, promote Dr. Hazzard’s successful transition to an independent research career.

## Key facts

- **NIH application ID:** 11141966
- **Project number:** 4R00HD108200-03
- **Recipient organization:** HENRY FORD HEALTH + MICHIGAN STATE UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Vivienne M Hazzard
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $249,000
- **Award type:** 4N
- **Project period:** 2024-08-22 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11141966

## Citation

> US National Institutes of Health, RePORTER application 11141966, Binge Eating as a Mechanism Underlying the Food Insecurity-Obesity Paradox in Adolescents (4R00HD108200-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11141966. Licensed CC0.

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