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Ariel Beccia receives the Ruth L. Kirschstein National Research Service Award Individual Predoctoral Fellowship

PhD candidate Ariel Beccia has received an NIH funded grant, the Ruth L. Kirschstein National Research Service Award Individual Predoctoral Fellowship, to support her research entitled “Intersectionality of Sexual Orientation, Gender Expression, and Weight Status on Risk of Disordered Eating Behaviors.” This study investigates the patterning and multilevel determinants of disordered eating behaviors within and across sexual minority subgroups with the intent of generating knowledge to inform future health equity efforts.
Sexual minorities who are gender nonconforming and/or of higher-weight status (i.e. overweight/obese) may have an especially high risk of engaging in disordered eating behaviors (DEBs), including severe calorie restriction, self-induced vomiting, laxative and diet pill use, and binge-eating. Sexual minorities who are gender nonconforming and/or of higher-weight status (i.e. overweight/obese) may have an especially high risk of engaging in these behaviors due to compounding social stressors.
Indeed, one in three sexual minority young people (lesbian, gay, bisexual, and other non-heterosexual individuals) engage in DEBs, a seven-fold higher odds than their heterosexual peers. There are considerable health consequences associated with these behaviors, such as metabolic and reproductive health issues, substance use, depression, and suicidality. However, research on DEBs is lacking, with critical gaps including failing to consider both within-group diversity in risk and the upstream social determinants of the observed disparities. Importantly, experiencing multiple forms of social disadvantage has been shown to increase risk of eating-related pathologies, including DEBs. Gender nonconforming and higher-weight (i.e., overweight/obese) are especially relevant dimensions of disadvantage to consider, as these groups experience high levels of appearance-based discrimination and may use DEBs as dangerous body-modification practices to cope. Sexual minorities who experience marginalization may encounter unique and/or compounding social stressors that exacerbate risk. Examining the intersectionality of sexual orientation, gender expression, and weight status is thus critical to addressing these research gaps. Using the Growing Up Today Study (GUTS), a national longitudinal cohort study of over 27,000 participants (~20% of whom are sexual minorities), this study aims to:
1) Quantify the intersectional effects of sexual orientation, gender expression, and weight status on risk of DEBs among young adults;
2) Quantify the effects of interpersonal-level determinants (bullying victimization, weight-based harassment) on risk of DEBs by sexual orientation, and evaluate differences by gender expression and/or weight-status; and
3) Quantify the effects of structural-level determinants (discriminatory social conditions, state policies) on risk of DEBs by sexual orientation, and evaluate differences by gender expression and/or weight-status.

The National Academy of Medicine’s 2011 landmark report on sexual minority health stressed the importance of adopting an intersectional framework for disparities research to inform the development of inclusive health equity efforts. Applying this lens through leveraging novel statistical methods will further understanding of a critically understudied sexual minority health issue and help identify high-risk subgroups and modifiable contextual risk factors.