Creating an appetite awareness and lifestyle modification intervention for Black women at risk for binge eating disorder: A pilot open trial.

Despite the availability of evidence-based interventions to improve binge eating, Black women have some of the lowest rates of access to care for eating disorders. Innovation is needed to offer accessible and culturally relevant treatment options. To this end, using an open trial design, we investigated the feasibility and acceptability of a group-based, appetite awareness training (AAT) + lifestyle modification (LM) programme in Black women at risk for BED in a primary care setting. Participants (n = 20) were Black women recruited from a family medicine centre affiliated with a local public university, and who reported at least two binge eating episodes in the last 28 days. Participants completed a 16-session AAT + LM programme over 4 months. Key outcomes were objective binge eating (assessed by the EDE and the EDE-Q), body dissatisfaction, and weight change, all assessed at baseline, four (post-treatment) and 6 months (2-month follow-up). Ninety-five percent of participants completed assessments at post-treatment and attended nearly 60% of intervention sessions. Among completers (n = 19), body dissatisfaction and objective binge eating decreased from baseline to post-treatment and this decrease was maintained at the 2-month follow-up. In exit interviews, participants reported programme satisfaction. Providing training in appetite awareness combined with lifestyle modification principles may be useful in the treatment of body dissatisfaction and binge eating among Black women.

The impact of COVID-19 on Black women who binge-eat: a qualitative study.

BACKGROUND: Although studies have traced the impact of COVID-19 on those with eating disorders, little is known about the specific impact of the pandemic on Black American women who report disordered eating behaviors and are at risk for eating disorders. Thus, the purpose of this study is to investigate the impact of COVID-19 on Black women who binge-eat. METHODS: We recruited a purposive sample during the first wave of COVID-19 from the southeastern United States. Participants identified as Black women, reported binge-eating episodes in the last 28 days, and agreed to participate in a semi-structured interview. Prior to the interview, participants were administered a socio-demographic survey and the Eating Disorder Examination-Questionnaire. Interviews were transcribed verbatim and analyzed independently using qualitative content analysis and open coding to identify relevant codes and themes. RESULTS: On average, participants (N = 20) were 43.05 ± 16.2 years of age and reported 5.6 ± 5.7 binge-eating episodes in the last 28 days. We identified six themes to describe participants' experiences managing their eating behavior during COVID-19: (1) food as a coping strategy; (2) lack of control around food; (3) increased time in a triggering environment (e.g., being at home with an easy availability of food); (4) lack of structure and routine; (5) challenges with limited food availability; and (6) positive impact of the pandemic. CONCLUSION: In this study, Black women reported challenges managing their eating behavior during COVID-19. Results could inform the development and tailoring of treatments for Black women reporting disordered eating behaviors. LEVEL OF EVIDENCE: Level V, qualitative interviews.

Recommendations to encourage participation of individuals from diverse backgrounds in psychiatric genetic studies.

We present innovative research practices in psychiatric genetic studies to ensure representation of individuals from diverse ancestry, sex assigned at birth, gender identity, age, body shape and size, and socioeconomic backgrounds. Due to histories of inappropriate and harmful practices against marginalized groups in both psychiatry and genetics, people of certain identities may be hesitant to participate in research studies. Yet their participation is essential to ensure diverse representation, as it is incorrect to assume that the same genetic and environmental factors influence the risk for various psychiatric disorders across all demographic groups. We present approaches developed as part of the Eating Disorders Genetics Initiative (EDGI), a study that required tailored approaches to recruit diverse populations across many countries. Considerations include research priorities and design, recruitment and study branding, transparency, and community investment and ownership. Ensuring representation in participants is costly and funders need to provide adequate support to achieve diversity in recruitment in prime awards, not just as supplemental afterthoughts. The need for diverse samples in genetic studies is critical to minimize the risk of perpetuating health disparities in psychiatry and other health research. Although the EDGI strategies were designed specifically to attract and enroll individuals with eating disorders, our approach is broadly applicable across psychiatry and other fields.