Multiply marginalized: Linking minority stress due to sexual orientation, gender, and weight to dysregulated eating among sexual minority women of higher body weight.

Abstract

This study assessed whether baseline levels of distal and proximal minority stressors related to sexual orientation, gender, and weight were associated with prospective risk for dysregulated eating in daily life among sexual minority women with overweight/obesity. Method: Fifty-five sexual minority women ages 18 -60 (M ϭ 25 Ϯ 9) with BMI Ͼ 25 kg/m 2 (M ϭ 32 Ϯ 5) completed baseline assessments of distal and proximal minority stressors due to sexual orientation, gender, and weight. Participants then completed an Ecological Momentary Assessment (EMA) protocol. For five days, participants responded to five random prompts assessing engagement in dysregulated eating (i.e., overeating, binge eating). The cumulative number of EMA-measured overeating and binge eating episodes was summed per participant. Results: Several minority stressors related to sexual orientation, gender, and weight were associated with prospective risk for dysregulated eating behaviors during EMA. Women with higher (vs. lower) baseline levels of internalized homophobia reported more cumulative episodes of binge eating during the EMA period. Women reporting greater (vs. less) baseline sexual orientation concealment reported more episodes of overeating during the EMA period. Women with greater (vs. less) baseline weight bias experiences and internalization reported more overeating and binge eating episodes during the EMA period. Conclusions: Findings from this pilot study identify internalized homophobia, sexual orientation concealment, and experienced and internalized weight bias as potential risk factors for dysregulated eating behaviors among sexual minority women of higher body weight.

A systematic review of sociodemographic reporting and representation in eating disorder psychotherapy treatment trials in the United States

“…Although there are limited data on the prevalence of EDs in older adult men (Schaumberg et al, 2017), women over the age of 50 are increasingly seeking treatment for new‐onset, chronic, and recurrent EDs (Samuels et al, 2019). Finally, a small, but growing body of research suggests individuals occupying multiple marginalized social identities are at elevated ED risk (Burke et al, 2020; Panza et al, 2021).…”

Women of diverse sexual identities admit to eating disorder treatment with differential symptom severity but achieve similar clinical outcomes

“…It is also possible that bisexual women's shape and weight concern severity is related to their higher average BMIs at admission than heterosexual women, given frequent societal stigmatization of individuals with higher weights (Prunty, Clark, Hahn, Edmonds, & O'Shea, 2020). In SM women, weight‐based discrimination is associated with dysregulated eating (Panza et al, 2020) and may negatively affect esteem in those with greater weight‐based preoccupation (Johns et al, 2017).…”

Addressing Weight Bias in the Cisgender Population: Differences between Sexual Orientations

“…Converging evidence has shown that minorities' stress due to sexual orientation could have a role in dysfunctional eating behaviors [18,20], but no specific conclusion about the relationship between these aspects has been drawn. Data are still preliminary, but recent studies have found both in sexual minority men and women the presence of higher BMI, higher levels of binge eating, and higher internalization of weight biases [21,22].…”