Professor University of Wyoming Laramie, Wyoming, United States
Abstract Text: Sexual and gender minority (SGM) individuals experience eating disorders at higher rates compared to their cisgender heterosexual peers. Minority stress theory posits that a combination of distal (i.e., discrimination) and proximal stress (i.e., internalized stigma, concealment) contribute to adverse mental health outcomes among SGM individuals. Further, minority stress theory posits that an individual’s coping capacity buffers against the detrimental impacts of minority stress. This model may be well suited to explain disparities in binge eating among SGM individuals given established links between negative affect and binge eating. The present study aimed to 1) examine whether proximal minority stress is associated with binge eating and 2) test whether difficulties with emotion regulation, a marker of coping capacity, moderated this link. I hypothesized that 1) internalized stigma and concealment, two forms of proximal minority stress, would be positively associated with binge eating and 2) nonacceptance of emotions and difficulties accessing emotion regulation strategies would moderate links between proximal minority stress and binge eating such that difficulties with emotion regulation would be associated with a stronger positive association between proximal minority stress and binge eating. A total of 219 SGM adults, recruited via Prolific, completed measures of minority stress, emotion regulation, and eating disorder psychopathology. Multiple linear regression analyses tested the effects of minority stress on binge eating and independently investigated whether emotion regulation facets moderated associations between each minority stress facet and binge eating. Internalized stigma (β=.34, t=4.77, p<.001), but not concealment (β=-.06, t=-.78, p=.438), was positively associated with binge eating. Emotion regulation facets did not moderate associations between proximal minority stress and binge eating (p’s>.2), however main effects of emotion regulation and internalized stigma on binge eating were observed. After removing the interaction term, internalized stigma (β=.31, t=4.42, p<.001) and nonacceptance of emotions (β=.21, t=2.97, p=.003) were both positively associated with binge eating. Concealment was not associated with binge eating in either model (p’s>.3) but both nonacceptance of emotions (β=.27, t=3.78, p<.001) and difficulties accessing emotion regulation strategies (β=.39, t=5.46, p<.001) were positively associated with binge eating after accounting for concealment. These findings indicate that emotion regulation and internalized stigma are both related to, and appear to be uniquely associated with, binge eating severity among SGM adults. Interventions that target emotion regulation and internalized stigma may be beneficial for SGM individuals experiencing binge eating. Further research is needed to understand the role of other emotion regulation facets and minority stress facets on binge eating. It is also unclear the extent to which these results generalize to other eating disorder symptoms (e.g., body dissatisfaction, excessive exercise, restriction).
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