RACIAL/ETHNIC DIFFERENCES OF EATING DISORDERS

RACIAL/ETHNIC DIFFERENCES
OF EATING DISORDERS
Undeniably, the stereotype exists that women who
suffer from eating disorders are young middle- to
upper-middle-class European Americans. However,
evidence is now emerging that eating disorders in fact
occur in a wide range of ethnic, cultural, and socioe-
conomic groups within the United  States. The esti-
mates of the prevalence of anorexia and bulimia in
non–European Americans can range from 1% to 4%,
depending on age, ethnicity, and location. The infer-
ences drawn from earlier studies were that ethnic and
racial differences in the prevalence of eating disorders
were linked to socioeconomic status. In other words,
as family or household income increases, so does the
rate of diagnosable eating disorders. Nevertheless, the
belief that non–European American women seldom
suffer from eating disorders contributes to barriers to
diagnosis, treatment, and prevention for women who
fit this description.
Of the many different racial groups, African
American women have probably been studied most
often to understand the complexity of their body
image and eating behavior. By and large, research on
African American women indicates that they are
more satisfied with their bodies than are their
European American counterparts. Nonetheless, they
still suffer from various types of disordered eating.
Most disordered eating among African Americans
has been found to be related to assimilation to
European American culture, as measured by the
Racial Identity Attitude Scale for African Americans.
Thus, as African Americans take on the values of the
larger (European American) culture, their rates of
eating disorders will increase. One large-scale inves-
tigation of eating disorders among African American
women shed light on this phenomenon. Essence
magazine conducted a survey asking readers about
disordered eating behavior and attitudes. Results
from the survey showed that more than half (53.5%)
of African American women respondents evidenced
some symptoms of eating disorders. Even though
there was no way to distinguish between those with
diagnosable eating disorders and symptoms of disor-
dered eating, such findings highlight the eating-
related struggles of African American women, an
overlooked population.
Only a few studies have investigated the eating
behaviors of Asian American women. Inconsistent
results regarding binge eating, vomiting, and bulimia
have been reported among Asian American popula-
tions. Some studies cite more vomiting and bulimia
among Asian Americans, whereas others state that the
rates are far lower among this group.
The Hispanic culture—similar to African American
culture—has a different standard of beauty that often
includes an acceptance of higher body weights. Thus,
Hispanic women are able to maintain some level of
body satisfaction despite their higher weights. The
research on Hispanic American women and eating
disorders, however, seems to be consistent. A small
amount of the research states that Hispanic women
have eating disorder rates similar to those of European
American women, and most of the remaining research
states that binge eating is more severe in this popula-
tion. Obesity is another factor directly related to binge
eating and has long been a major health issue in the
Hispanic population.
Another American minority group that may be
affected by the dominant European American cul-
ture’s focus on weight and body size is Native
Americans. One study has found that Native
American adolescents received significantly higher
dieting and restricting/ purging scores than their
European American counterparts. A high percentage
of individuals attempting to control their weight
through controlled eating could suggest a higher
prevalence of eating disorders among this group. Still,
there has been such a deficiency of research on this
population that no significant estimates of disordered
eating can be declared.
166———Eating DisordersThe characteristic that all of the studies regarding
minority women and eating disorders highlight is
acculturation, defined as the process of assimilating
new ideas into an existing cognitive structure. Thus,
the more acculturated to American values—especially
those regarding appearance—minority women are,
the higher their risk for developing eating disorders.
It seems that there are no ethnic differences in the
likelihood of obtaining treatment for eating disorders.
However, there may be such forces at work as referral
bias. In other words, clinicians might have a tendency to
refer only patients who look like the stereotypical indi-
vidual who suffers from an eating disorder. Other issues
come into play, such as cultural values about seeking
help and fears about being treated unfairly by health
professionals, that also contribute to treatment seeking
for eating disorders among minority women. Further
research is needed to examine ways that we as a society
can begin to diminish the numbers of women suffering
from this condition. Despite the growing interest in and
concern about the risks, consequences, and treatment of
eating disorders, little is known about effective means
of preventing these disorders. An understanding of pre-
vention is urgently needed to combat this growing
threat to the health of women in this country.
—Jameca Falconer
See also DSM-IV; Models of Mental Health
FURTHER READING
American Psychiatric Association. (2000). Diagnostic and sta-
tistical manual of mental disorders, fourth edition, text
revision (DSM-IV-TR). Washington, DC: Author.
Brock, K. J. (1999). Exploring evidence for a continuum of eat-
ing disturbances: Self-objectification, parental attachment,
and sociotrophy-autonomy in college women. Unpublished
doctoral dissertation, University of Missouri– Columbia.
National Institute of Mental Health. (1996).  Mental health
research in eating disorders (NIMH Publication No. PA-
96-064). Bethesda, MD: Autho