(PS8-B43) Stigmatization of Binge Eating Disorder: Implicit Associations with Weight Status and Femininity

Mental health disorders are generally stigmatized, but the degree and types of negative attitudes vary substantially by condition. The primary aim of this study was to add to our understanding of the extent and nature of stigma directed at individuals with binge eating disorder (BED), which is relatively understudied compared to other eating disorders. We compared perceptions of BED patients to individuals with alcohol use disorder (AUD), which is known to be highly stigmatized and shares the key characteristic and possible driver of stigma of subjective loss of control over consumption. We also investigated how participants’ self-reported alcohol use and binge eating behaviors and their attitudes to and experiences with psychological treatment influences their ratings of a target described as suffering from BED or AUD. Participants (n=402 undergraduates, 58.7% female) were randomized to view one of two vignettes, describing a male target suffering from either AUD or BED. The vignettes were identical, except for the behavior described (drinking versus binge eating). Participants rated the target on twenty-one attributes (e.g., impulsive, intelligent, strong) and indicated their perception of each as suffering from an addictive disorder in need of treatment. Participants also completed the Alcohol Use Disorders Identification Test, Binge Eating Scale, and questions about attitudes towards and prior experience with psychological treatment. There was a significant multivariate main effect of vignette type (AUD vs. BED) on combined ratings of the target [p=.001, η_p²=.37]. The BED target was rated as significantly less “thin,” more “overweight,” and more “obese”, and received significantly higher ratings of “feminine” and traits traditionally associated with femininity such as “nurturing” and “kind” than the AUD target (all p< .05). The AUD target was perceived as significantly more likely to be suffering from an addiction and in need of psychological treatment than the BED target. There were no significant differences between respondents rating the AUD and BED targets in the belief that the person described is responsible for or in control over their behavior. There were no significant main effects of attitudes towards or prior experience with psychological treatment on combined ratings of the target and no interactions with vignette type. Ratings of the targets were unrelated to participants’ own alcohol consumption or binge eating behaviors. Findings suggest that BED is implicitly associated with weight status. Compared to the AUD target, the BED target was rated significantly higher on “active” and “strong,” suggesting an association with positive physical traits despite perceived links of binge eating with overweight/obesity. Our data signal the persistent misconception that eating disorders are a female phenomenon, with most respondents rating the BED target as significantly more “feminine” compared to the AUD target. The AUD target was significantly more likely to be perceived as suffering from an addiction and in need of psychological treatment compared to the BED target, though ratings were high for both targets, suggesting that respondents generally recognized BED as pathological and warranting intervention.