Impact of culture on eating behaviors and body image among Black women in the United States: A qualitative study

Background: Despite similar or higher prevalence of binge eating disorder and binge eating, Black women are less likely to be assessed for eating disorders, less likely to seek and/or receive eating disorder treatment, and more likely to drop out of treatment compared to other women. Efforts to improve early detection and interventions for Black women are hindered by the lack of knowledge about pathways for eating disorder psychopathology in this understudied and underserved population. The aim of this study was to explore how culture influences eating behaviors among Black women in the United States.Methods: Seven Black women completed semi-structured, in-depth interviews. Interview transcripts were analyzed using reflexive thematic analysis.Results: Four main themes were derived from the qualitative data: 1) Childhood: Moments That Shape Us, 2) Crossroads: Navigating the Clash of Two Norms, 3) The Ripple Effect: The Power of Social Influence, and 4) Feeding Feelings: When Emotions Drive Eating.Conclusions: Eating disorder models can be strengthened to represent the experiences of Black women and should consider their ethnic heterogeneity such as African, African American, and Afro-Caribbean. Such knowledge can then be used to inform conceptual frameworks to transform assessments and interventions, leading to more treatment efficacy and a decrease in attrition.