Ethnic/racial and gender differences in disordered eating behavior prevalence trajectories among women and men from adolescence into adulthood

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Abstract

Background: Disordered eating behaviors (DEB) are highly prevalent and are associated with negative long-term health outcomes. Extant research on DEB prevalence trajectories has predominantly focused on white women, thereby lacking both gender and ethnic/racial diversity, which may lead to preventive interventions that are not optimally timed for socially minoritized groups. The purpose of this study was to identify patterns in DEB trajectories from adolescence to adulthood across intersecting gender and ethnic/racial identities. Methods: Participants (n = 1314) were from Project EAT (Eating and Activity in Teens and Young Adults), a population-based sample in the United States. Unhealthy weight control behaviors and binge eating were assessed across four waves at 5-year intervals. Gender-stratified generalized estimating equations (GEE) analyses were applied to examine ethnic/racial and gender differences in the prevalence trajectories of two forms of DEB (unhealthy weight control behaviors and binge eating). Results: Hispanic/Latina young women reported heightened prevalence of unhealthy weight control behaviors and binge eating during adolescence (82.4% and 31.1%) relative to women with other ethnic/racial identities (44–70.2% and 8.8–18.2%) at any other developmental time point. Black/African American women reported linear increases in unhealthy weight control behaviors from adolescence (46.6%) to adulthood (65.5%), with nearly 20% greater prevalence relative to white women (44.6%) during adulthood. Among men, prevalence of unhealthy weight control behaviors was higher among Hispanic/Latinos (60.7–68.0%) and Asian Americans (41.9–56.7%) relative to Black/African American (24.6–36.9%) and white men (25.7–34.9%). Similarly, Hispanic/Latino young men reported up to ten or more times higher prevalence of binge eating during adolescence (22.8%) and adulthood (26.8%) relative to men from other ethnic/racial identities at any other time point (1.7–12.3%). Conclusions: Ethnic/racial disparities in DEB prevalence vary across development, DEB subtype, and by gender. Targeted preventive interventions, or interventions that address these different trajectories, that are optimally timed may reduce these disparities.

Original languageEnglish (US)
Article number114720
JournalSocial Science and Medicine
Volume294
DOIs
StatePublished - Feb 2022

Bibliographical note

Funding Information:
The Tripartite Influence model for DEB was originally developed for and tested among samples largely comprised of white women in the United States. While emerging evidence suggests that the Tripartite Influence model may have relevance for women with other ethnic/racial identities (Burke et al., 2021), little attention has focused on the integration of culturally relevant variables, and even less focus has been directed on etiological pathways among ethnically and racially minoritized men. Indeed, a number of ethnic/racial identity-related processes and experiences may reduce (e.g., family support for larger body shapes) or increase (e.g., interpersonal discrimination, food precarity) DEB risk (Burke et al., 2020). For instance, evidence suggests that Hispanic/Latina and Asian American women may experience additional forms of sociocultural pressures resulting from two distinct cultural beauty ideals, which in turn increases DEB risk (Romo et al., 2016; Akoury et al., 2019). Additional research has revealed associations between acculturative stress and DEB among Asian American women and both Hispanic/Latina/Latino women and men (Kroon Van Diest et al., 2014; Akrouy et al., 2019; Kwan et al., 2018). Thus, the failure to integrate potentially relevant cultural factors that may contribute to DEB brings cause for concern, as the translation of a theoretical model devised to explain DEB onset among white women to men and women with different ethnic/racial identities ignores the influence of potentially relevant cultural factors and structural minoritizing factors present in the United States.Research is supported by grant number R35HL139853 (PI: Neumark-Sztainer) from the National Heart, Lung, and Blood Institute, T32MH082761 (PI: Scott Crow) from the National Institute of Mental Health, and K99MD015770 (PI: Simone) from the National Institute of Minority Health and Health Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding Information:
Research is supported by grant number R35HL139853 (PI: Neumark-Sztainer) from the National Heart, Lung, and Blood Institute , T32MH082761 (PI: Scott Crow) from the National Institute of Mental Health , and K99MD015770 (PI: Simone) from the National Institute of Minority Health and Health Disparities . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2022 Elsevier Ltd

Keywords

  • Adolescence
  • Adulthood
  • Developmental trajectories
  • Disordered eating behaviors
  • Ethnic/racial minority health
  • Prevalence trajectories

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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