This study found an association between perceived racial discrimination with emotional eating behaviors and perceived stress levels among obese African-American women, as supported in other literature (Cozier et al., 2009
; O’Connor, Jones, Conner, McMillan, & Ferguson, 2008
; Vines et al., 2007
). The study by O’Connor and colleagues (2008)
of 428 obese women and men used diary reports of daily hassles/stressors along with dietary intake. Daily hassles/stressors were defined as ego threatening, interpersonal, or work related. These authors reported a positive association between daily hassles and unhealthy eating behaviors, with the participants consuming more high fat (p
< 0.001) and sugar (p
< 0.001) snacks.
The present study found no association between weight status (BMI group) and discrimination, which is similar to the findings of several other studies (Hunte & Williams, 2009
; Shelton et al., 2009
). Nevertheless, others have found associations with weight-related variables. Gee and colleagues (2008)
found a positive association between BMI and discrimination among Asian Americans. Cozier and colleagues (2009)
, in the Black Women’s Health Study, found that an increase in perceived discrimination at baseline was associated with higher weight gain at an 8-year follow-up.
The present study also found no association between waist circumference and discrimination. Other researchers found higher waist circumference, with higher discrimination, in a study of middle-aged (35 to 47 years of age), obese, premenopausal African-American or Black women (Vines, et al., 2007
). Moreover, an increase in waist circumference was associated with high and persistent racism in a multicultural prospective study (Hunte, 2011
). More specifically, Lewis, Kravitz, Janssen, and Powell (2011)
described an association of reported discrimination with higher visceral fat (in and around internal organs) but not higher subcutaneous fat (close to the surface of the skin).
The lack of association between weight status and perceived discrimination found in this paper might be due to certain design limitations. First, the range of weight status, while large, did not include many women with a BMI in the normal range, and no women in the underweight range, which limits the assessment of association of one variable with another. Also, the measure of perceived discrimination that was used in this study was very general, and only a single item was used to measure perceived stress. Wyatt et al. (2003)
identified three ways that discrimination might increase risk of cardiovascular disease including: institutional racism, with associated decreased socioeconomic opportunity and poor living conditions; personally-mediated racism, which acts as a stressor; and, true internalized racism, which comes from internalization of negative stereotypes. The Kreiger measure used in the SisterTalk
study encompasses only personally mediated racism. Future studies should examine relationships of physical outcomes, including BMI, with other types/measures of discrimination.
It was hypothesized that perceived discrimination could be induced by stress, and indeed it was related to stress in the current cross sectional analysis, but the causal pathway is not clear. Previous research by Walcott-McQuigg (1995)
demonstrated a higher likelihood of being overweight and the use of fewer weight control behaviors with higher stress. Also, women who were obese were more likely to report “confrontive coping,” or directly confronting life problems, which might have included weight problems, compared with normal weight participants, but no association was found with weight and perceived stress, social support, or stressful life events (Strickland, Giger, Nelson, & Davis, 2007
). The measurement of stress in more depth with attention to sources of stress and coping mechanisms is warranted in future research.
Even without a direct association with weight, the association of discrimination and stress with emotional eating is concerning. Others have explored the neurochemical effects of racism as a stressor, including the direct and indirect effects on blood pressure (Krieger, 2000
; Wyatt et al., 2003
). Stressors in general have been shown to be associated with increased food intake. In animal models, stress that causes activation of the hypothalamus pituitary adrenal (HPA), or chronic stress axis, is associated with increased food intake and increased preference for sweets. In humans, the effect of greater intake of snack food with daily stressors was found only among individuals with high reactions to stress in some research (Adam & Epel, 2007
). Daily hassles have been associated with increased food intake, in contrast with physical threat stressors that were associated with lower food intake (O’Connor et al., 2008
), demonstrating again the very different dietary responses to different stressors. However, the more direct effect of racism-associated stress on eating behaviors has not heretofore been identified. In this study, stress was associated with both discrimination and emotional eating, however, further longitudinal studies are needed to establish a causal relationship.