Discrimination as a risk factor for binge eating in stigmatized groups

Thesis (M.A.)--University of Hawaii at Manoa, 2007.Includes bibliographical references (leaves 48-54).viii, 82 leaves, bound 29 cmObjective: The present study examined the relationship between experiences of discrimination and occurrence of binge eating among members of two traditionally stigmatized groups - obese persons and gay, lesbian, and bisexual (GLB) persons - which have previously shown elevated rates of binge eating. Method: Participants completed a series of questionnaires presented on the Internet which measured frequency of overt and subtle acts of discrimination as well as the impact of that discrimination. Participants also completed measures of eating-related beliefs and behaviors, including drive for thinness, bulimic symptomology, body satisfaction, binge eating frequency and emotional eating. Previously identified risk factors for binge eating - childhood weight, maternal and paternal body types, childhood teasing, and perceived stress - were measured to compare the relative effect of discrimination on occurrence of binge eating. Additional questionnaires were given to measure the level of internalized homophobia among the GLB participants and the level of internalized weight bias among the overweight/obese participants. Results: Results demonstrated a significant positive relationship between the occurrence of discrimination and the frequency of binge eating and emotional eating. Group membership was associated with having faced a major discriminatory event and with endorsing at least one binge episode in the last 6 months. Pearson correlation analyses demonstrated modest but significant positive relationships between the measures of discrimination and measures of eating behaviors (r = 0.19-0.37); nearly all coefficients remained significant when controlling for Body Mass Index or perceived stress. Regression models which included previously identified risk factors for binge eating and discrimination frequencies as independent variables all significantly predicted between 9 and 30% of the variance of emotional eating scores, bulimic symptomology, and frequency of binge eating. Perceived stress and day-to-day discrimination emerged as the only significant independent predictors in the regression models. The theoretical model laid out in this study demonstrated good fit to the data for the overweight participants, explaining 57% of the variance in eating disturbance. Weight bias internalization was found to be a partial mediator of the relationship between discrimination and eating disturbance. Discussion: Results demonstrate the importance of discrimination as a risk factor for binge eating. Internalization is identified as an important mechanistic pathway and potential treatment target; therapeutic interventions are suggested on both the individual and societal level. The implications suggested by the data about the unique features of weight-related bias are drawn out and discussed