Multiply Marginalized: Linking Minority Stress Due to Sexual Orientation, Gender, and Weight to Dysregulated Eating Among Sexual Minority Women of Higher Body Weight

Public Significance Statement This study identified minority stress due to sexual orientation and body weight as potential risk factors for dysregulated eating among sexual minority women of higher body weight. These findings highlight the need for future research examining weight disparities and intersecting minority stressors among sexual minority women, with the goal of improving treatments to reduce obesity and improve health in this underserved group. Objective: This study assessed whether baseline levels of distal and proximal minority stressors related to sexual orientation, gender, and weight were associated with prospective risk for dysregulated eating in daily life among sexual minority women with overweight/obesity. Method: Fifty-five sexual minority women ages 18-60 (M = 25 +/- 9) with BMI > 25 kg/m(2) (M = 32 +/- 5) completed baseline assessments of distal and proximal minority stressors due to sexual orientation, gender, and weight. Participants then completed an Ecological Momentary Assessment (EMA) protocol. For five days, participants responded to five random prompts assessing engagement in dysregulated eating (i.e., overeating, binge eating). The cumulative number of EMA-measured overeating and binge eating episodes was summed per participant. Results: Several minority stressors related to sexual orientation, gender, and weight were associated with prospective risk for dysregulated eating behaviors during EMA. Women with higher (vs. lower) baseline levels of internalized homophobia reported more cumulative episodes of binge eating during the EMA period. Women reporting greater (vs. less) baseline sexual orientation concealment reported more episodes of overeating during the EMA period. Women with greater (vs. less) baseline weight bias experiences and internalization reported more overeating and binge eating episodes during the EMA period. Conclusions: Findings from this pilot study identify internalized homophobia, sexual orientation concealment, and experienced and internalized weight bias as potential risk factors for dysregulated eating behaviors among sexual minority women of higher body weight.