Those who reported racial discrimination had a 3.31 greater risk of developing BED.

The Adolescent Brain Cognitive Study is the largest prospective study of adolescent brain development in the U.S. This study (ABCD Study ®) is a longitudinal study of nearly 12,000 youth conducted at 21 research sites across the country. Most young people studied are 10 to 11 years old. This landmark study explores the environmental, social, genetic, and biological factors that affect brain and cognitive development, behavior, and health. [For more information on the ABCD Study, contact ABCD Project Director Dr. Gaya Dowling at 301-443-4877 or online at: AdolescentBrain@mail.nih.gov.]

A connection to BED

A growing number of studies have found significant associations between racial discrimination and binge eating in African American and Hispanic populations. This can occur in schools, during extracurricular activities, and increasingly digitally and online (Curr Psychiatry Rep. 2021. 23:81).

A team led by Dr. Julia H. Raney at the University of California-San Francisco analyzed cross-sectional data from 11,075 teens from the ABC Study to find if racial discrimination reached out to younger teens, and then led to BED (J Eat Disord. 2023. 11:39). In their study, conducted from 2018 to 2020, racial/ethnic discrimination and binge-eating behaviors were assessed with the Perceived Discrimination Scale, which analyzes discrimination based on race/ethnicity and frequency of ethnic discrimination by teachers, adults outside of school, and other students. The scale measures adolescents’ perception of not being accepted in society or unwanted in general, based on their racial or ethnic backgrounds. The students assessed were from a wide variety of ethnic groups: 54% were white, 24% Latino/Hispanic, 17% African American, 6% Asian, 3.2% Native American, and 1.4% were classified as “other.” Students were recruited from Boys and Girls Clubs and other youth groups.

At one-year follow-up, BED diagnoses and behaviors were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia, which was completed by parents or caregivers. This computerized tool records characteristics, frequency and duration of a child’s binge-eating behaviors, and stress associated with binge eating. Although the test also contains binge-eating behaviors and symptoms, the prevalence from the sample included only 6 adolescents diagnosed with BED.

Other students: the main perpetrators of discrimination

Approximately 1 in 20 of the youths reported experiencing racial or ethnic discrimination during their first year in school. In addition, there was a statistically significant difference in discrimination scores across groups where other students were by far the greatest source of racial discrimination (teachers, 8.0%; adults; 9.8%, and other students, 25.1%).

The authors reported that 1.1% of the socio-demographically diverse sample of early adolescents had a BED diagnosis, similar to earlier reports, which have shown prevalence estimates of 1.3% to 1.6% (Eur Child Adolesc Psychiatry. [Internet] 2021; 67:41). Young adolescents who reported perceived discrimination had 3.31 higher odds of developing BED. Increased discrimination by other students was also significantly associated with higher odds of BED diagnosis and behaviors. Also, respondents who reported more frequent ethnic discrimination by adults outside of school had significantly higher odds of having a diagnosis of BED.

Other students were the main culprits who perpetuated racial discrimination. Prior studies have also pointed to the impact of other students on stress and mental health. Encountering discrimination by other adults outside of school was also associated with a significantly higher chance of a BED diagnosis in young teens. This finding is also reflected in other studies, which show the beneficial effects that nonparental adults, such as mentors and police officers, can have on adolescent mental health (JAMA Pediat. 2022. 176:78).

Results of a Federal Task Force review of screening programs

The U.S. Preventive Services Task Force recently reviewed eating disorders screening in asymptomatic adolescents and adults, but found there was not enough evidence to recommend routine screening, especially among racial/ethnic populations. However, the authors suggest clinicians consider screening for eating disorder behaviors in early teens who have significant risk factors, such as reports of racial discrimination. They also recommend a second step, implementing strategies such as the “Raising Resisters” approach. This program helps individuals recognize various forms of racism, differentiating racism from other unfair treatment, and opposing negative messages, and helps students replace them with positive actions and messages.