Combating Binge Eating Disorder in Ethnic Minorities

Black and Hispanic women have elevated risks for developing binge eating disorder (BED), perhaps in part because these women also have high rates of obesity. Minority women are also less likely to seek treatment for obesity, and are more likely to drop out of treatment than are women from other ethnic groups. This may be in part because traditional BED treatment approaches may be less acceptable to Black and Hispanic women (World Psychiatry. 2007. 6:142).

In hopes of addressing these trends, researchers at the University of Texas and the University of Southern California designed a lifestyle community intervention program, Health is Power (HIP). The goal of this longitudinal randomized controlled trial was to promote physical activity and improve dietary habits among minority ethnic women (Appetite. 2015. 95:269). Scherezade K. Mama, DrPh, and colleagues recruited 180 African American and Hispanic women in Houston and Austin, TX and randomized them to a physical activity group or a dietary habits intervention group. All the women attended 6 intervention sessions held over 24 weeks. At the beginning, the intervention sessions were held biweekly and then were scheduled monthly. These 60-minute sessions were led by two trained health educators. During the intervention sessions, the women learned about goal-setting, the benefits of being physically active, or eating more fruits and vegetables, self-sufficiency, social support, and ways to prevent relapse. Binge eating and its symptoms were not explicitly discussed or addressed as part of the intervention.

At two time points, before the study began and after it ended, all participants had the following anthropomorphic measurements taken: height, weight, and percent body weight, and these were then used to compute body mass index. Ethnicity, educational level, and household income were measured with the Maternal and Infant Health Assessment Questionnaire. Dietary habits were tallied using the National Cancer Institute Fruit and Vegetable Screener, and dietary fat intake was measured with the Fat Screener. The Fat Screener measures usual dietary fat intake over a year by measuring how often the individual consumes 15 target foods. The Binge Eating Scale was also used.

Results

The women in this study were of relatively high socioeconomic status, and nearly 75% were Black and roughly 25% were Hispanic. The authors also reported that 72% of the women were non-binge eaters, 22% were binge eaters, and 5% had severe binge-eating symptoms. The women classified as binge eaters reporter higher dietary fat consumption than the non-binge eaters.

At the end of the intervention, the researchers found that 82% of the women were classified as non-binge eaters and 18.3% as binge eaters. That is, 50% of women classified as binge eaters at baseline were classified as non-binge eaters at follow-up. Slightly more women in the physical activity study group were reclassified as non-binge eaters at the follow-up point.

This study suggests that lifestyle intervention to improve physical activity may be a useful strategy for reducing symptoms of binge eating; according to the authors, it is also the first to address BED among ethnic minority women. The intervention improved daily fruit and vegetable intake by an average of 14%. Body composition did not significantly change even though binge eating symptoms and dietary habits did.

The study did have some limitations. Chiefly, since their study population involved women with relatively high socioeconomic status, it is not clear whether the authors recommend that results can be generalized to other populations such as lower-income minorities, or to men.