2020 Dr. Jerome Kaplan Outstanding Graduate Paper

Athena Koumoutzis, MA

Miami University

Risk factors for poor health behaviors among family caregivers: The role of demographic characteristics and family context.

Athena Koumoutzis and Kelly E. Cichy

Overeating and obesity are major public health issues in the United States.  Health problems linked to obesity include: Type 2 diabetes, various cancers, stroke, and joint disease. Almost 15 million individuals serve as informal caregivers to older adults (Wolff, Spillman, Freedman, & Kasper, 2016) and 18% of children in the United States have a developmental disability (Zablotsky et al., 2019) that requires extended care. Prior literature has found that caregivers are at risk of engaging in poor health behaviors, such as emotional eating (i.e., eating in response to stressors and negative affect; MacDougall & Steffen, 2017; Tomiyama, Finch, & Cummings, 2015), to cope and self-medicate with the associated stress of providing caregiving assistance (MacDougall & Steffen, 2017).  To our knowledge, a limited amount of research has focused on emotional eating in family caregivers (MacDougall & Steffan, 2017) or has only focused on weight gain as an outcome of caregiver stress (Fredman & Daly, 1997). 

The present study addresses this gap in the literature by examining how caregiver characteristics (i.e., age, gender, and BMI) are associated with emotional eating among family caregivers. Using Lazarus and Folkman’s (1984) Transactional Model of Stress and Coping Model, this study examines the associations between caregiver characteristics (i.e., age, gender, & BMI) and emotional eating, including the extent to which family strain mediates these associations.  Data are from the MIDUS 3 dataset (N = 326) and include family caregivers of older adults and children with health care needs (M = 62.88, SD = 10.28).  Female caregivers (M=4.27, SD=2.02) were more likely than male caregivers (M=3.18, SD=1.38) to engage in emotional eating. There were no age differences in propensity to engage in emotional eating. ANOVA results indicated that obese caregivers (M = 4.68, p < .0001) were the most likely to engage in emotionally eating.

Results also indicated that family strain significantly mediated the association between caregiver age and emotional eating. Linear regression analyses indicated that female gender predicted emotional eating, although family strain did not mediate the association between gender and emotional eating. Similarly, after controlling for family strain as a mediator, higher BMI was still significantly associated with emotional eating, suggesting that BMI is a strong predictor of emotional eating among family caregivers regardless of present family strain. Interventions targeted at managing family strain, particularly for younger, female caregivers, could improve coping and decrease poor health behaviors.



Fredman, L., & Daly, M. P. (1997). Weight change: An indicator of caregiver stress. Journal of Aging and Health, 9(1), 43–69.doi.org/10.1177/089826439700900103

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

MacDougall, M., & Steffen, A. (2017). Self-efficacy for controlling upsetting thoughts and emotional eating in family caregivers. Aging & Mental Health, 21(10), 1058–1064.

Tomiyama, A. J., Finch, L. E., & Cummings, J. R. (2015). Did that brownie do its job? Stress, eating, and the biobehavioral effects of comfort food. In Emerging Trends in the Social and Behavioral Sciences (pp. 1–15). American Cancer Society. doi.org/10.1002/9781118900772.etrds0324

Wolff, J. L., Spillman, B. C., Freedman, V. A., & Kasper, J. D. (2016). A National Profile of Family and Unpaid Caregivers Who Assist Older Adults With Health Care Activities. JAMA Internal
Medicine, 176(3), 372–379. doi.org/10.1001/jamainternmed.2015.7664

Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. (2019). Prevalence and Trends of Developmental
Disabilities among Children in the United States: 2009–2017. Pediatrics, 144(4).



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