The Impact of Racial and Socioeconomic Disparities on Binge Eating and Self-Efficacy Among Adults in a Behavioral Weight-Loss Study

Background and Purpose:The prevalence of obesity is significantly higher among racial and ethnic minorities and those of low socioeconomic status (SES). Current rates of obesity are highest in Non-Hispanic blacks (47.8%), and then in Hispanics (42.5%), non-Hispanic whites (32.6%), and non-Hispanic Asians (10.8%). Behavioral strategies (e.g. diet, physical activity) are recommended to aid in weight reduction. However, psychosocial barriers (e.g. binge eating, low self-efficacy) hinder the adoption of a more healthful diet. Binge eating behaviors are associated with severe obesity, and lower rates of self-efficacy are linked with decreased likelihood of practicing weight management behaviors. There is limited research identifying racial and SES differences in binge eating and self-efficacy. Conducting this research may allow investigators to increase the effectiveness of weight management interventions. Thus, the purpose of this study is to examine socioeconomic and racial differences in binge eating and eating self-efficacy in individuals seeking weight loss treatment.

Method: This is a secondary analysis of baseline data from EMPOWER, a 12-month behavioral intervention for weight loss. Data were collected in two-phases: during screening for study eligibility and at baseline. Linear regression analyses examined associations among age, gender, race, years of education, income, and employment and these psychosocial measures:  Binge Eating Scale (BES) and Weight Efficacy Lifestyle Questionnaire (WEL). The WEL has 5 subscales: negative emotions (I can resist eating when angry), availability (I can control my eating on weekends), social pressure (I can resist eating even when I have to say no to others), physical discomfort (I can resist eating when feeling physically run down), and positive activities (I can resist eating when watching TV).

Results: Participants included 151 overweight and obese adults. The sample was 90.73% female, 79.47% white and 20.53% non-white, with a mean (±SD) age of 51.18±10.22 years. On average, participants completed 16.42 years of education. Less than 3% of the sample had incomes <$20,000, followed by 12.67% in the range of $20-39,999, and 15.34% in the range of $40-59,999. Linear regression analyses revealed that having fewer years of education (b=-.44, p = .04) and being non-white (b=3.18, p=.03) were associated with higher scores on the availability subscale of the WEL. Being non-white was associated with higher scores on the social pressure subscale (b=3.80, p = .01) and total scores on the WEL (b=13.96, p = .02). No significant associations were found between the socio-demographic variables and scores on the BES.

Conclusion and Implications: Participants who self-identified as ethnic minorities or had fewer years of education exhibited more confidence resisting eating when food was available. Minority participants reported more self-confidence eating under social pressure and had higher total weight loss self-efficacy scores than white participants. These results suggest culture and education may influence the level of self-efficacy participants have resisting eating. It is imperative that social workers join researchers in understanding the cultural and environmental dynamics behind participant perception about eating behaviors. Future research should explore factors contributing to higher weight loss self-efficacy in non-whites, and uncover additional reasons for the continued disparity in obesity rates.