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Gordon AR, Beccia AL, Egan N, Lipson SK. Intersecting gender identity and racial/ethnic inequities in eating disorder risk factors, symptoms, and diagnosis among U.S. college students: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy. Int J Eat Disord 2024; 57:146-161. [PMID: 37933620 PMCID: PMC10842502 DOI: 10.1002/eat.24089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION There are documented inequities in eating disorders (EDs) by gender and race/ethnicity, yet, little is known about population-level prevalence of ED risk factors, symptoms, and diagnosis at the intersection of diverse gender and racial/ethnic identities. METHODS Data from the Healthy Minds Study 2015-2019 (N = 251,310 U.S. university students) were used in a multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). Participants were nested in 35 intersectional strata given by all combinations of 5 gender and 7 racial/ethnic categories. Multilevel logistic models with participants at level 1 and intersectional strata at level 2 were used to estimate stratum-specific predicted prevalence estimates for self-reported thin-ideal internalization, ED symptoms, and ED diagnosis. The variance partition coefficient (VPC) was calculated to quantify the contextual effect of the strata. RESULTS There was considerable heterogeneity in the predicted prevalence of our ED outcomes across the strata (e.g., .3%-18.3% for ED diagnoses). There were large disparities in all three outcomes, with transgender participants of color having a higher predicted prevalence than expected based on the additive effects of gender and race/ethnicity. Moderation by race/ethnicity was also apparent, such that racial/ethnic disparities were wider within the cisgender groups relative to the transgender groups. VPCs indicated that ~10% of the total variance in ED outcomes was due to intersectionality between gender and race/ethnicity, over and above variance due to individual-level differences. CONCLUSION Findings suggest that gender and racial/ethnic disparities in EDs are interrelated, underscoring the need to develop preventive interventions centering health equity. PUBLIC SIGNIFICANCE Despite evidence that sexism, racism, and cissexism (i.e., anti-transgender prejudice) can impact EDs risk, little research examines the social patterning of EDs at the intersection of diverse gender and racial/ethnic identities. Using data from a sample of 250,000 U.S. university students, this study found that gender and racial/ethnic disparities in eating disorder risk are interrelated, highlighting the need to develop health equity centered preventive interventions.
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Affiliation(s)
- Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ariel L. Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Natalie Egan
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah K. Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA USA
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Zhao Z, Serier KN, Smith BN, Vogt D, Kehle-Forbes S, Mitchell KS. Gender similarities and differences in associations between weight discrimination, shape/weight concerns, and eating disorder symptoms among post-9/11 veterans. Eat Behav 2023; 51:101818. [PMID: 37741082 DOI: 10.1016/j.eatbeh.2023.101818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE Weight discrimination, defined as mistreatment of people based on body weight, is associated with body image concerns and eating disorder (ED) symptoms. Military veterans are particularly vulnerable to developing ED symptoms, which may be due to experiences of weight discrimination resulting from the military's strict weight and fitness requirements. However, no previous study has examined these associations among veterans. We investigated relationships between weight discrimination during and after military service and shape/weight concerns and ED symptoms in post-9/11 veterans. Based on evidence for gender differences in weight discrimination, body image, and ED symptoms, we also examined whether gender moderated these associations. METHOD Participants were randomly selected from the population of post-9/11 U.S. veterans who had been discharged from the military within the previous 18 months. A total of 1494 veterans completed the Everyday Discrimination Scale, Eating Disorders Examination-Questionnaire, and the Eating Disorder Diagnostic Scale-5. RESULT Women were more likely to report weight discrimination and had higher levels of ED symptoms and shape/weight concerns than men. Weight discrimination in and after leaving the military were positively associated with shape/weight concerns and ED symptoms in the full sample and among men and women. Gender moderated the association between weight discrimination after leaving the military and shape/weight concerns such that the association was stronger among men. DISCUSSION Both male and female veterans may be vulnerable to developing ED symptoms, in part due to weight discrimination experienced during and after military service. Our findings emphasize the need to address weight discrimination and its consequences in veterans.
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Affiliation(s)
- Ziyu Zhao
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychological & Brain Science, Boston University, United States of America
| | - Kelsey N Serier
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America
| | - Brian N Smith
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America
| | - Dawne Vogt
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America
| | - Shannon Kehle-Forbes
- National Center for PTSD at VA Boston Healthcare System, United States of America; Minneapolis VA Healthcare System, United States of America; Department of Medicine, University of Minnesota, United States of America
| | - Karen S Mitchell
- National Center for PTSD at VA Boston Healthcare System, United States of America; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, United States of America.
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Zhang X, Wang H, Kilpatrick LA, Dong TS, Gee GC, Labus JS, Osadchiy V, Beltran-Sanchez H, Wang MC, Vaughan A, Gupta A. Discrimination exposure impacts unhealthy processing of food cues: crosstalk between the brain and gut. NATURE MENTAL HEALTH 2023; 1:841-852. [PMID: 38094040 PMCID: PMC10718506 DOI: 10.1038/s44220-023-00134-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/28/2023] [Indexed: 12/17/2023]
Abstract
Experiences of discrimination are associated with adverse health outcomes, including obesity. However, the mechanisms by which discrimination leads to obesity remain unclear. Utilizing multi-omics analyses of neuroimaging and fecal metabolites, we investigated the impact of discrimination exposure on brain reactivity to food images and associated dysregulations in the brain-gut-microbiome system. We show that discrimination is associated with increased food-cue reactivity in frontal-striatal regions involved in reward, motivation and executive control; altered glutamate-pathway metabolites involved in oxidative stress and inflammation as well as preference for unhealthy foods. Associations between discrimination-related brain and gut signatures were skewed towards unhealthy sweet foods after adjusting for age, diet, body mass index, race and socioeconomic status. Discrimination, as a stressor, may contribute to enhanced food-cue reactivity and brain-gut-microbiome disruptions that can promote unhealthy eating behaviors, leading to increased risk for obesity. Treatments that normalize these alterations may benefit individuals who experience discrimination-related stress.
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Affiliation(s)
- Xiaobei Zhang
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Hao Wang
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- School of Physics and Optoelectronic Engineering, Hainan University, Haikou, China
| | - Lisa A. Kilpatrick
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Tien S. Dong
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Goodman–Luskin Microbiome Center, UCLA, Los Angeles, CA, USA
| | - Gilbert C. Gee
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Community Health Sciences Fielding School of Public Health, UCLA, Los Angeles, CA, USA
- California Center for Population Research, UCLA, Los Angeles, CA, USA
| | - Jennifer S. Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Goodman–Luskin Microbiome Center, UCLA, Los Angeles, CA, USA
| | - Vadim Osadchiy
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Urology, UCLA, Los Angeles, CA, USA
| | - Hiram Beltran-Sanchez
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Community Health Sciences Fielding School of Public Health, UCLA, Los Angeles, CA, USA
- California Center for Population Research, UCLA, Los Angeles, CA, USA
| | - May C. Wang
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Community Health Sciences Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Allison Vaughan
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Goodman–Luskin Microbiome Center, UCLA, Los Angeles, CA, USA
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Raney JH, Al-Shoaibi AA, Shao IY, Ganson KT, Testa A, Jackson DB, He J, Glidden DV, Nagata JM. Racial discrimination is associated with binge-eating disorder in early adolescents: a cross-sectional analysis. J Eat Disord 2023; 11:139. [PMID: 37592364 PMCID: PMC10433622 DOI: 10.1186/s40337-023-00866-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/09/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Racial and ethnic discrimination are known stressors and are associated with negative psychological and physical health outcomes. Previous studies have found relationships between racial/ethnic discrimination and binge-eating disorder (BED), though they have mainly focused on adult populations. The aim of this study was to determine associations between racial/ethnic discrimination and BED in a large, national cohort study of early adolescents. We further sought to explore associations between the racial/ethnic discrimination perpetrator (students, teachers, or other adults) and BED. METHODS We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (N = 11,075, 2018-2020). Logistic regression analyses examined associations between self-reported experiences of racial or ethnic discrimination and binge-eating behaviors and diagnosis, adjusting for potential confounders. Racial/ethnic discrimination measures were assessed based on the Perceived Discrimination Scale, which measures experiences of discrimination based on race/ethnicity and frequency of ethnic discrimination by teachers, adults outside of school, and students. Binge-eating behaviors and diagnosis were based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSAD-5). RESULTS In this racially diverse sample of adolescents (N = 11,075, age range 9-12 years), 4.7% of adolescents reported racial or ethnic discrimination and 1.1% met the criteria for BED. In the adjusted models, racial/ethnic discrimination was associated with 3 times higher odds of having BED (OR 3.31, CI 1.66-7.74). Further, experiences of ethnic discrimination by students and adults outside school were associated with significantly increased odds of BED diagnosis (OR 1.36, CI 1.10-1.68 and OR 1.42 CI 1.06-1.90, respectively)., Increased odds of binge eating behaviors were only significantly associated with ethnic discrimination perpetuated by students (OR 1.12, CI 1.02-1.23). CONCLUSIONS Children and adolescents who have experienced racial/ethnic discrimination, particularly when discrimination was perpetuated by other students, have higher odds of having binge-eating behaviors and diagnoses. Clinicians may consider screening for racial discrimination and providing anti-racist, trauma-informed care when evaluating and treating patients for BED.
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Affiliation(s)
- Julia H Raney
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA.
| | - Abubakr A Al-Shoaibi
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA
| | - Iris Y Shao
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, 518172, China
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA
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Chalmers A, Austen E, Griffiths S. Aboriginal and/or Torres Strait Islander women's body image: A qualitative study. Body Image 2022; 43:474-485. [PMID: 36347166 DOI: 10.1016/j.bodyim.2022.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Abstract
Aboriginal and/or Torres Strait Islander peoples refer to the traditional owners of Australia and have the oldest continuing culture in the world. Body image has scarcely been investigated among adult Aboriginal and/or Torres Strait Islander (Indigenous) women, despite evidence that racism and colourism broadly contribute to adverse psychological outcomes for this population. Therefore, we conducted a qualitative study investigating Indigenous womens' body image with specific focus on racism, colourism, and cultural identity. Sixteen Indigenous women completed individual interviews or took part in group yarns - a culturally sanctioned method of information sharing. A reflexive thematic analysis generated three themes: (i) Dominant beauty ideals in Australia exclude Indigenous women and are informed by colonisation and stereotypes of what Indigenous women "should" look like, (ii) Variations in Indigenous women's identities and appearances influences the types of discrimination that they receive and impacts their sense of belonging, and (iii) A change journey occurs over time towards body acceptance which is informed by changes in understandings of body image and cultural identity. Broadly, participants described racism and colourism as negatively impacting their body image. Importantly, developing a strong cultural identity mitigated these impacts by facilitating both a sense of belonging and body acceptance - highlighting a potential protective factor.
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Affiliation(s)
- Aliya Chalmers
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.
| | - Emma Austen
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Simone M, Slaughter‐Acey J, Hazzard VM, Eisenberg M, Neumark‐Sztainer D. Exploring the intersection of multiple social determinants of health and disordered eating behaviors in a population-based sample in the United States. Int J Eat Disord 2022; 55:1589-1602. [PMID: 36324296 PMCID: PMC9633979 DOI: 10.1002/eat.23795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Disordered eating behaviors (DEBs) have long-term, deleterious effects on health and are more prevalent among socially marginalized groups, likely as a result of systemic inequities across social determinants of health (SDoH). This exploratory study aimed to identify subgroups of emerging adults characterized by main and interactive associations between SDoH and two forms of DEB (binge eating, extreme unhealthy weight control behaviors). METHOD Participants (n = 1568; age 22.2 ± 2.1 years) from the United States were drawn from the EAT 2010-2018 longitudinal study. Conditional inference tree (CIT) analyses derived main and intersecting SDoH related to DEB across 33 input variables collected during adolescence and emerging adulthood. RESULTS The binge eating CIT revealed five subgroups (prevalence: 6.3-23.2%) shaped by variables collected during emerging adulthood: appearance-based teasing (p < .001), financial difficulty (p = .003), gender (p < .001), and everyday discrimination (p = .008). The CIT results for extreme unhealthy weight control behaviors derived six subgroups (prevalence: 2.3-45.5%) shaped by weight teasing (p < .001) and gender (p < .001) during emerging adulthood and public assistance (p = .008) and neighborhood safety (p = .007) in adolescence. DISCUSSION This exploratory study revealed distinct subgroups of emerging adults with varying DEB prevalence, suggesting that variability in DEB prevalence may be partially explained by intersecting SDoH during adolescence and emerging adulthood. Hypothesis-driven research and replication studies are needed to further explore the associations between SDoH and DEB during emerging adulthood. PUBLIC SIGNIFICANCE STATEMENT Disordered eating behaviors are common among young people in the United States and have long-term health consequences. This exploratory study identified subgroups of young people, characterized by combinations of social inequities (e.g., financial difficulties, teasing). Results highlight high-risk subgroups of emerging adults that should be examined further in hypothesis-driven research.
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Affiliation(s)
- Melissa Simone
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Jaime Slaughter‐Acey
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Vivienne M. Hazzard
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Marla Eisenberg
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Dianne Neumark‐Sztainer
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
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Parker JE, Enders CK, Mujahid MS, Laraia BA, Epel ES, Tomiyama AJ. Prospective relationships between skin color satisfaction, body satisfaction, and binge eating in Black girls. Body Image 2022; 41:342-353. [PMID: 35551032 DOI: 10.1016/j.bodyim.2022.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 11/25/2022]
Abstract
Although it has been demonstrated that (a) body dissatisfaction and internalization of societal appearance standards contribute to disordered eating and (b) that internalization of societal appearance standards leads to decreased skin color satisfaction among Black women, it has not been established whether skin color dissatisfaction contributes to disordered eating among Black women or girls. The objective of the present study is to determine the influence of skin color satisfaction as a potential predictor for binge eating, and its effect through body image in Black girls during the vulnerable developmental period of adolescence. Using data from ten annual measurements in 1213 Black girls across ages 10-19, we sought to determine whether skin color satisfaction predicts Binge Eating Disorder (BED) risk and symptoms using pre-registered logistic and multilevel models. We found that lower skin color satisfaction at ages 13 and 14 significantly predicted greater odds of BED and lower skin color satisfaction at all ages predicted greater BED symptoms. Body satisfaction mediated the relationship between skin color satisfaction and BED symptoms. Our results suggest that skin color dissatisfaction is a novel component of body image for Black girls that is also related to binge eating.
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Affiliation(s)
- Jordan E Parker
- University of California Los Angeles, Department of Psychology, 502 Portola Plaza, Los Angeles, CA 90095, United States
| | - Craig K Enders
- University of California Los Angeles, Department of Psychology, 502 Portola Plaza, Los Angeles, CA 90095, United States
| | - Mahasin S Mujahid
- University of California Berkeley, School of Public Health, Division of Epidemiology, Haviland Hall, Berkeley, CA 94720-7358, United States
| | - Barbara A Laraia
- University of California, Berkeley School of Public Health, Division of Public Health Nutrition, 207B University Hall, Berkeley, CA 94720, United States
| | - Elissa S Epel
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, & Center for Health and Community, University of California, 3333 California St, Ste 465, San Francisco, CA 94122, United States
| | - A Janet Tomiyama
- University of California Los Angeles, Department of Psychology, 502 Portola Plaza, Los Angeles, CA 90095, United States.
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Shank LM, Moursi NA, Tanofsky-Kraff M. Loss-of-Control Eating and Cardiometabolic Health in Relation to Overweight and Obesity. Curr Diab Rep 2022; 22:257-266. [PMID: 35403985 DOI: 10.1007/s11892-022-01466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Loss-of-control (LOC) eating, the subjective feeling of being unable to control what or how much is being consumed, is common. The purpose of this review was to examine the relationships among LOC eating, cardiometabolic health, and weight management intervention outcomes. RECENT FINDINGS In youth and adults, LOC eating is associated with and predictive of psychological symptoms, high weight, and worsened cardiometabolic health. While LOC eating pre-intervention does not appear to impact outcomes, LOC eating during or following is associated with worsened outcomes from behavioral and surgical weight management interventions. When individuals are undergoing weight management interventions, it may be important to regularly assess for LOC eating. There is limited research on the examined relationships in diverse populations (e.g., males, individuals of a lower socio-economic status, racial/ethnic minority groups). Future research should examine these relationships across the lifespan in diverse populations, with a focus on how these relationships can be impacted through targeted interventions.
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Affiliation(s)
- Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Nasreen A Moursi
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Bray B, Bray C, Bradley R, Zwickey H. Binge Eating Disorder Is a Social Justice Issue: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts' Opinions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6243. [PMID: 35627779 PMCID: PMC9141064 DOI: 10.3390/ijerph19106243] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional study assessed whether there is consensus among experts in the field about environmental factors that influence adult binge eating disorder pathology. METHODS Fourteen expert binge eating disorder researchers, clinicians, and healthcare administrators were identified internationally based on federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Semi-structured interviews were recorded anonymously and analyzed by ≥2 investigators using reflexive thematic analysis and quantification. RESULTS Identified themes included: (1) systemic issues and systems of oppression (100%); (2) marginalized and under-represented populations (100%); (3) economic precarity and food/nutrition insecurity/scarcity (93%); (4) stigmatization and its psychological impacts (93%); (5) trauma and adversity (79%); (6) interpersonal factors (64%); (7) social messaging and social media (50%); (8) predatory food industry practices (29%); and (9) research/clinical gaps and directives (100%). CONCLUSIONS Overall, experts call for policy changes around systemic factors that abet binge eating and for greater public education about who can have binge eating disorder. There is also a call to take and account for the narratives and life experiences of individuals with binge eating disorder to better inform our current understanding of the diagnosis and the environmental factors that impact it.
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Affiliation(s)
- Brenna Bray
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
| | - Chris Bray
- Wilder Research Division, Amherst H. Wilder Foundation, Saint Paul, MN 55104, USA;
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 97037, USA
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 97037, USA
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Ibekwe LN, Atkinson JS, Guerrero-Luera R, King YA, Rangel ML, Fernández-Esquer ME. Perceived Discrimination and Injury at Work: A Cross-Sectional Study Among Latino Day Laborers. J Immigr Minor Health 2022; 24:987-995. [PMID: 35094213 PMCID: PMC9262804 DOI: 10.1007/s10903-022-01329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Given the stigma of their undocumented status and their high prevalence of workplace injury, understanding the impact of discrimination on Latino day laborers (LDLs) is a critical public health issue. METHODS We surveyed LDLs (N = 149) and assessed their sociodemographics, experiences of and perceived reasons for discrimination, and work-related injury. A logistic regression examined the association between discrimination and injury, adjusting for sociodemographics. Next, Chi-square tests identified perceived reasons for discrimination associated with injury which were then included in a second logistic regression to test their association with injury, adjusting for discrimination and sociodemographics. RESULTS Participants reported a work-related injury (42%) and experiences of discrimination (81%). Discrimination was associated with injury in the first model (aOR = 2.25, p = 0.049), and discrimination attributed to immigration status was associated with injury in the second model (aOR = 5.04, p = 0.019). DISCUSSION Injury prevention programs should account for perceived mistreatment to reduce LDL risk for injury at work.
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What Are the Relationships between Psychosocial Community Characteristics and Dietary Behaviors in a Racially/Ethnically Diverse Urban Population in Los Angeles County? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189868. [PMID: 34574791 PMCID: PMC8468734 DOI: 10.3390/ijerph18189868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/22/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022]
Abstract
To address existing gaps in public health practice, we used data from a 2014 internet panel survey of 954 Los Angeles County adults to investigate the relationships between psychosocial community characteristics (PCCs) and two key chronic disease-related dietary behaviors: fruit and vegetable (F+V) and soda consumption. Negative binomial regression models estimated the associations between 'neighborhood risks and resources' and 'sense of community' factors for each dietary outcome of interest. While high perceived neighborhood violence (p < 0.001) and perceived community-level collective efficacy (p < 0.001) were associated with higher F+V consumption, no PCCs were directly associated with soda consumption overall. However, moderation analyses by race/ethnicity showed a more varied pattern. High perceived violence was associated with lower F+V consumption among White and Asian/Native Hawaiian/Other Pacific Islander (ANHOPI) groups (p < 0.01). Inadequate park access and walking as the primary mode of transportation to the grocery store were associated with higher soda consumption among the ANHOPI group only (p < 0.05). Study findings suggest that current and future chronic disease prevention efforts should consider how social and psychological dynamics of communities influence dietary behaviors, especially among racially/ethnically diverse groups in urban settings. Intervention design and implementation planning could benefit from and be optimized based on these considerations.
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Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge MP. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2021; 143:e984-e1010. [PMID: 33882682 PMCID: PMC8493650 DOI: 10.1161/cir.0000000000000973] [Citation(s) in RCA: 907] [Impact Index Per Article: 302.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.
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Prevalence and Correlates of Disinhibited Eating in Youth from Marginalized Racial/Ethnic Groups. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-020-00347-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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