Racial/ethnic differences in adults in randomized clinical trials of binge eating disorder.

Abstract

Objective Recent studies suggest that binge eating disorder (BED) is as prevalent among African American and Hispanic Americans as among Caucasian Americans; however, data regarding the characteristics of treatment-seeking individuals from racial and ethnic minority groups are scarce. The purpose of this study was to investigate racial/ethnic differences in demographic characteristics and eating disorder symptoms in participants enrolled in treatment trials for BED. Method Data from 11 completed randomized, controlled trials were aggregated in a single database, the Clinical Trials of Binge Eating Disorder (CT-BED) database, which included 1,204 Caucasian, 120 African American, and 64 Hispanic participants assessed at baseline. Age, gender, race/ethnicity, education, body mass index (BMI), binge eating frequency, and Eating Disorder Examination (EDE) Restraint, Shape, Weight, and Eating Concern subscale scores were examined. Results Mixed model analyses indicated that African American participants in BED treatment trials had higher mean BMI than Caucasian participants, and Hispanic participants had significantly greater EDE shape, weight, and eating concerns than Caucasian participants. No racial or ethnic group differences were found on the frequency of binge eating episodes. Observed racial/ethnic differences in BED symptoms were not substantially reduced after adjusting for BMI and education. Comparisons between the CT-BED database and epidemiological data suggest limitations to the generalizability of data from treatment-seeking samples to the BED community population, particularly regarding the population with lower levels of education. Conclusions Further research is needed to assess alternative demographic, psychological, and culturally specific variables to better understand the diversity of treatment-seeking individuals with BED.

Race/ethnicity, education, and treatment parameters as moderators and predictors of outcome in binge eating disorder.

“…A thorough search for data appropriate for inclusion was conducted, including a literature search using online databases (e.g., CRISP; Clinicaltrials.gov; PubMed), in order to locate all the studies of BED that met the following criteria: (a) was a randomized, controlled trial; (b) included a psychosocial intervention arm; (c) included > 10 participants overall and presence of participants from African American or Hispanic/Latino racial/ethnic groups; (d) was either published in a peer reviewed journal or funded through a peer review process and; (e) was conducted in the United States (see also Franko et al, 2011, for original report on methods). Fourteen studies were identified through the search, some of which were multi-site studies.…”

“…The Human Subjects Review committees of each of the original data sites, as well as the principal investigators’ institutions (Boston University and Northeastern University), approved the inclusion of data from the original trials in this study. (See also Franko et al, 2011, for additional details. )…”

“…For this study, education was dummy-coded as 1 = high school/GED or less, and 2 = some college or more. We chose a break point after the high school level to capture important variance in education based on prior examination of epidemiological data concerning BED (Franko et al, 2011). …”

“…The limited research conducted has found racial/ethnic differences in baseline clinical characteristics, with higher body mass index (BMI) and associated dietary restraint observed among African Americans, and greater shape and weight concerns among Hispanic/Latinos, compared to Caucasians (see Franko et al, 2011). Racial/ethnic differences in recruited clinic samples relative to community samples have also been observed (Grilo, Lozano, & Masheb, 2005; Pike, Dohm, Striegel-Moore, Wilfley, & Fairburn, 2001).…”

Eating disorders in men aged midlife and beyond

“…Emerging epidemiological data suggests that binge eating disorder has a less skewed age and gender distribution than anorexia and bulimia nervosa, with an average age at treatment presentation in the mid-40s [29]. For example, Franko and colleagues [30] analyzed aggregate data from 11 completed randomized, controlled trials for BED (N = 1325) and found the average age at treatment was 47.0 years (SD = 10.7) for Caucasians, 45.1 years (SD = 11.4) for African Americans, and 42.7 years (SD = 10.1) for Hispanics.…”