Disordered Eating Symptom Profiles in Low-Income, Racially Minoritized Adults

Eating disorder (ED) research has traditionally assumed that symptoms cluster in the same way across populations. If this assumption is incorrect, models and assessment tools developed with advantaged samples may miss substantial symptom burden in marginalized populations. We investigated, for the first time, how ED symptoms cluster in racially minoritized, low-income adults.

We used latent profile analysis to identify empirically derived ED symptom profiles in an intersectionally marginalized sample of women and men living in Detroit (N = 561; 87.5% Black; modal annual income < $10,000). We then applied BCH estimation to examine how demographic factors (age, sex, racial identity, and body mass index [BMI]) related to profile membership.

The best-fitting model included seven profiles, some of which meaningfully differed from existing ED diagnostic categories and clinical heuristics. For example, two elevated symptom profiles were predominantly male, and participants in the profiles with the highest levels of restraint also had the highest BMIs. The highest levels of binge eating were observed in participants with relatively low co-occurring restraint. The most acute symptom profile was characterized by high body dissatisfaction, anxiety, depression, and restraint due to both monetary and weight/shape concerns.

Disordered eating may present differently in disadvantaged populations, with decoupling of mechanisms that are more tightly linked in relatively advantaged settings (e.g., binge eating and restraint). Co-occurring restraint due to monetary and weight/shape concerns appears to be common, highlighting the importance of attending to multiple drivers of disordered eating in individuals from marginalized backgrounds.