Pathways to Binge Eating Among Black Adults With Type 2 Diabetes: A Grounded Theory Qualitative Study

OBJECTIVE Black adults with type 2 diabetes (T2D) are at higher risk for binge eating and often face challenges in achieving blood glucose control, which may be due to untreated disordered eating. Little is known about the influences on their eating behaviors in the context of T2D. This study explores factors influencing binge eating in Black adults with T2D and the perspectives of the diabetes self-management education and support (DSMES) providers treating them. RESEARCH DESIGN AND METHODS Black adults with T2D experiencing at least two self-reported binge eating episodes a month (n = 14) and DSMES providers (n = 8) who treated this population participated in in-depth interviews. Interviews explored experiences with managing T2D and facilitators of binge eating. A constructivist grounded theory approach was used to analyze the data and develop a framework explaining factors influencing binge eating in this population. RESULTS Participants identified multilevel stressors and barriers that influenced their binge eating episodes and treatment. These factors ranged from societal to individual-level and physiological factors that led to active food restriction, emotional eating, feelings of deprivation, and binge eating. Providers acknowledged limited training in disordered eating and weight stigma and identified gaps in current DSMES. CONCLUSIONS Binge eating in Black adults with T2D is shaped by structural, cultural, and psychological factors. Incorporating culturally responsive guidance, emotion-focused coping strategies, and routine screening for disordered eating into diabetes care may improve engagement and glycemic outcomes for this population.