Adolescents who face racial and/or ethnic discrimination, particularly from fellow students, are more likely to engage in binge-eating behaviors and receive a binge-eating disorder (BED) diagnosis, according to study findings published in the Journal of Eating Disorders. Accordingly, screening for racial discrimination and offering trauma-informed care may be helpful for patients with BED.
To examine the associations between discrimination and binge eating, researchers examined survey data collected between 2018 and 2020 from the Adolescent Brain Cognitive Development (ABCD) Study. The ABCD study is a large cohort study of brain development and health behaviors among early adolescents in the United States. Racial and ethnic discrimination in this cohort was evaluated using the Perceived Discrimination Scale, which measured adolescents’ perceptions of discrimination over the 12 months prior to evaluation. The primary outcomes of binge-eating behaviors and BED diagnoses were determined by parent/caregiver responses on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSAD-5), a computerized tool based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
The 11,075 adolescents (aged 9-12) included in the analyses were racially and ethnically diverse (53.4% White, 19.6% Latino/Hispanic, 16.5% Black, 5.6% Asian, 3.2% Native American, 1.4% Other). Of the participants, 7.9% (n=791) exhibited binge-eating behaviors and 1.1% had a diagnosis of BED (n=105). Moreover, approximately 4.7% of adolescents experienced racial or ethnic discrimination within the past year. Of that 4.7%, discrimination from students (25.1%) occurred at a significantly higher rate (F statistic 630; P <.001) than perpetuation from teachers (8.0%) or adults outside of school (9.8%).
Logistic regression models were used to estimate the associations between racial/ethnic discrimination, BED diagnosis, and binge-eating behaviors. In the model considering all confounding variables, adolescents who perceived discrimination because of race, ethnicity, or color had 3.29 higher odds of BED diagnosis (95% CI, 1.65-6.57; P <.05) and 2.12 higher odds of binge-eating behaviors (95% CI, 1.50-3.00; P <.001).
When stratified by the groups that perpetuated this discrimination, the odds ratio (OR) of BED diagnosis was significantly higher for instances committed by students (OR, 1.36; 95% CI, 1.10-1.68; P <.01) or adults outside of school (OR, 1.42; 95% CI, 1.06-1.90; P <.05). For binge-eating behaviors, only student discrimination had a significant impact (OR, 1.12; 95% CI, 1.02-1.23; P <.05).
These findings demonstrate that perceived racial/ethnic discrimination is significantly associated with higher odds of binge-eating behaviors and BED diagnosis in a younger population than those previously studied.
The researchers concluded, “Further research is needed to identify eating disorder treatment strategies that effectively provide coping strategies to manage racial/ethnic discrimination.”
Raney JH, Al-Shoaibi AA, Shao IY, et al. Racial discrimination is associated with binge-eating disorder in early adolescents: a cross-sectional analysis. J Eat Disord. Published online August 17, 2023. doi:10.1186/s40337-023-00866-0