Carolyn Blair Burnette

Objective: Eating disorder (ED) research has traditionally assumed that symptoms cluster in the same way across populations. If this assumption is incorrect, models and assessment tools developed with advantaged samples may miss substantial symptom burden in marginalized populations. We investigated, for the first time, how ED symptoms cluster in racially minoritized, low‐income adults. Method: We used latent profile analysis to identify empirically derived ED symptom profiles in an intersectionally marginalized sample of women and men living in Detroit ( N = 561; 87.5% Black; modal annual income < $10,000). We then applied BCH estimation to examine how demographic factors (age, sex, racial identity, and body mass index [BMI]) related to profile membership. Results: The best‐fitting model included seven profiles, some of which meaningfully differed from existing ED diagnostic categories and clinical heuristics. For example, two elevated symptom profiles were predominantly male, and participants in the profiles with the highest levels of restraint also had the highest BMIs. The highest levels of binge eating were observed in participants with relatively low co‐occurring restraint. The most acute symptom profile was characterized by high body dissatisfaction, anxiety, depression, and restraint due to both monetary and weight/shape concerns. Discussion: Disordered eating may present differently in disadvantaged populations, with decoupling of mechanisms that are more tightly linked in relatively advantaged settings (e.g., binge eating and restraint). Co‐occurring restraint due to monetary and weight/shape concerns appears to be common, highlighting the importance of attending to multiple drivers of disordered eating in individuals from marginalized backgrounds.

As online research has proliferated, so too have threats to data integrity. Recent literature continues to raise concerns with survey fraud and threats to data integrity in online eating disorder (ED) research. In this commentary, we expand on recent work by describing threats to data integrity we are currently encountering in our online studies. Specifically, we describe how agentic AI is enabling malicious actors to learn in real time , quickly bypassing exclusion criteria and recommended safeguards (e.g., validation questions, tasks) to gain study access. Further, we note a disturbing trend of voice‐based bots capable of participating in phone screens, and ostensibly other study tasks (e.g., interviews). Safeguards that could be reasonably trusted to identify fraudulent responses five, even 1 year ago, are likely inadequate now in the face of rapidly advancing technology. At the same time, increased efforts to protect online data integrity will almost invariably involve added resources and inefficiencies (e.g., manual review of all responses, phone screens) that could deter the very humans we hope to recruit. We argue that data integrity is essential for scientific advancement and equity; therefore, researchers must stay vigilant and prioritize data integrity above convenience, efficiency, and productivity.

Intuitive eating is a non-diet approach that emphasizes eating in response to hunger and fullness cues that has potential as a sustainable health promotion framework. Although research demonstrates that intuitive eating is strongly associated with psychological health, less is known about its associations with health behaviors and physical health. We examined how intuitive eating related to lifestyle behaviors and chronic disease diagnosis in a large, diverse U.S. adult sample. Adults aged ≥ 18 years residing in the U.S. were recruited from CloudResearch’s Connect platform to complete a cross-sectional online survey on self-reported stress, health behaviors, and current or previous chronic health conditions. Regression models adjusting for age, sex, and race/ethnicity were conducted. Our sample ( N = 1057; M _age = 36 ± 11 years) was 52% female and diverse across race/ethnicity (13% Asian/Hawaiian/Pacific Islander, 21% Black, 18% Latine, 58% White) and socioeconomic status (e.g., 30% food insecure). Higher intuitive eating scores were associated with greater physical activity ( p = .01), more sleep ( p < .001), and self-reported health ( p < .001) and lower self-reported stress ( p < .001). Intuitive eating was not significantly associated with fruit/vegetable intake or substance use. However, it was associated with lower odds of current or previous hypertension ( p < .001), hyperlipidemia ( p < .001), and type 2 diabetes ( p = .01), with small to moderate effects. Findings suggest that intuitive eating is not only associated with psychological health, but also health-promoting behaviors and reduced odds of cardiometabolic conditions. Although longitudinal and intervention studies are needed, results highlight intuitive eating as a promising framework for chronic disease prevention and health promotion.

Research has demonstrated the salience of parental communication toward children’s maladaptive eating outcomes, but less work has examined its association with more adaptive outcomes. Thus, the current study explored the link between parental communication about health-promoting behaviors in adolescence and intuitive eating behaviors both cross-sectionally and longitudinally. Analyses included 2,615 Project EAT (2010-2023) participants who completed surveys in adolescence, and were followed up in emerging adulthood (n=1489), and adulthood (n=936) assessing verbal and nonverbal parental communication about diet and physical activity in adolescence and intuitive eating at each time point. Linear mixed-effects models were used to estimate the association between each parental communication variable and intuitive eating across waves. Results indicate significant cross-sectional associations between parental encouragement of healthy eating, parental modeling of healthy eating, and parental modeling of physical activity with intuitive eating. Parental modeling of healthy eating persisted as a significant predictor of intuitive eating across all time points, whereas parental encouragement of healthy eating and parental modeling of physical activity did not maintain significant associations with intuitive eating beyond adolescence. Thus, findings support the notion that parents’ diet-related behaviors may be a key consideration for promoting intuitive eating, highlighting nonverbal communication as a potentially important factor in children’s adaptive eating outcomes.

Experiences of discrimination exert a significant psychological toll. However, to our knowledge, no studies have examined longitudinal associations between discrimination and disordered eating (DE) in intersectionally marginalized adults. We investigated associations between discrimination and DE symptoms (binge eating, restraint, body dissatisfaction, weight preoccupation, and emotional eating) cross-sectionally and longitudinally in a predominantly Black, low-income sample of adults ( N = 561). Using multilevel structural equation modeling, we found that greater discrimination was associated with all DE symptom domains at a between-person levels and greater binge eating and body dissatisfaction at a within-person level. Greater within-person discrimination was also associated with increased within-person binge eating a year later. Covarying demographic factors had little impact on effect sizes. Attributions of discrimination (e.g., to weight, sex, or race) moderated associations between discrimination and DE differentially across symptom domains. Addressing discrimination and related stress may help reduce eating-disorder risk and promote health equity.

Over the past 50 years, there has been a significant increase in research on eating disorders, which is encouraging and necessary given the substantial mortality, morbidity, and personal and societal costs of these common conditions. However, improvements in prevention, treatment access, and outcomes have been slow, and research priorities have not always been aligned with the needs and interests of affected communities. In this commentary, we call on the field to think critically about how to maximize not only the volume but also the real‐world impact of the next 50 years of eating disorder research. In particular, we highlight the importance of creating a research ecosystem that nurtures methodological diversity and centers collaborative, participatory research in partnership with people with lived experience. We also underscore the importance of conducting inclusive research that makes space for the full diversity of eating disorder presentations and the people who experience them. Ultimately, we argue that creativity and commitment will be required along with shifts in training, academic incentives, and broader structures to realize the full potential of research to enhance the lives of those with eating disorders.