The Prevalence of Eating Disorders in Communities of the Black Diaspora

By: Makeeda Bandele-Asante

CP in Dietetics

Howard University

Food choices are impacted by culture, environment, finances, and lifestyle. Eating disorders can be impacted by these same factors and can lead to physical and emotional problems, such as weight loss, poor self image, difficulties setting boundaries relating to food, and social withdrawal.

In the 2022 book It's Time to Correct the Narrative Surrounding Black Girls and Eating Disorders, Anissa Gray writes about how dinnertime attendance was mandatory, whether her and her siblings enjoyed the food or not. Although traditions like this don’t inherently lead to major issues surrounding food, they can make space for an absence or delayed healthy relationship with food. Across the Black Diaspora, a variation of phrases are used such as having "baby fat" that should go away with age, being"big-boned", needing "meat on your bones", and having "child-bearing hips". These comments aren't always triggering, but they can create body insecurity, impact food intake, and encourage disordered eating patterns.

Source: For Those With Eating Disorders, Holidays In A Pandemic Can Create Extra Anxiety. Houston Public Media.

The study titled Prevalence of Eating Disorders (ED) among Blacks in the National Survey of American Life is the first study of its kind to examine demographic differences among Black American and Caribbean adults. The purpose of it was to 1) address limitations of past studies of ED among the population and 2) provide context for features of ED among the population. The results revealed that the prevalent ED: Binge eating is the most prevalent, ED is the least prevalent ED, and no notable differences in prevalence estimates for ED were found between Black Caribbean and Black American adults. Conclusions made from the study are that 1) clinicians must prepare and train to recognize and treat ED in ethnically-diverse populations; 2) binge eating rates may reflect environmental stressors rather than concern for smaller body size; 3) once poor dietary habits are formed, they are difficult to change; and 4) a reason for these populations experiencing a higher prevalence of BN has been postulated to be associated with stress, including acculturated stress.

As research has a primary focus on Whites, the Gender and Ethnic Differences in the Association Between Body Image Dissatisfaction and Binge Eating Disorder among Blacks study reviewed differences in body image dissatisfaction and binge eating in Black adults in the US and Caribbean. The results reveal that African Americans described higher body image dissatisfaction and there is a stronger connection between body image dissatisfaction & lifetime binge eating in Caribbean Blacks. It is important to note that ethnic variation could be due to cultural differences in body image between the ethnicities, including different expectations, definitions, norms. This is another reason why clinicians must prepare and train to recognize and treat ED in ethnically-diverse populations.

The study titled Classification and Correlates of Eating Disorders among Blacks: Findings from the National Survey of American Life had the purpose of examining correlations of eating disorders among Blacks in the US and in the Caribbean. 66% of African American and 59% Caribbean Black adults were overweight/obese; 30% of adolescents were overweight/ obese. Although lifetime rates of anorexia nervosa and bulimia nervosa were low, binge eating disorder was high for both ethnic groups among adults and adolescents.

Work done by public health professionals including researchers and clinicians can be used by policy makers to address eating disorders on a systemic level through health equity efforts. Health equity centers the social determinants of health and does not involve unfair, avoidable obstacles to health. Poverty and discrimination are the targets of health equity efforts, as they make space for the systemic barriers to proper education and access to diet and nutrition. As defined by Healthy People 2022, a health disparity is “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage” and notes that disparities, “adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion (Disparities in Health and Health Care: 5 Key Questions and Answers). As defined by the Centers for Disease Control and Prevention (CDC), health disparities is a “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations (Disparities in Health and Health Care: 5 Key Questions and Answers).

Considering that these disparities lead to health inequity, which results from poverty, environmental threats, poor access to healthcare, educational inequality, and more, these factors must be addressed to target the root causes of the problem. Anti-racism should be centered around this work, as white supremist ideology stemming from hundreds of years of oppression is the root of our current health-related systems.

Source: Disparities in Health and Health Care: 5 Key Questions and Answers. Kaiser Family Foundation.

It is up to us all to encourage more studies, progressive policies, and funding that addresses disordered eating and the many socioeconomic causes of them.

References

Blostein, F., Assari, S., & Caldwell, C. H. (2016). Gender and ethnic differences in the association between body image dissatisfaction and binge eating disorder among blacks. Journal of Racial and Ethnic Health Disparities, 4(4), 529–538. https://doi.org/10.1007/s40615-016-0255-7

Eating Disorders. (n.d.). NAMI. Retrieved May 21, 2022, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Eating-Disorders

Ndugga, N., & Artiga, S. (2021, May 11). Disparities in Health and Health Care: 5 Key Questions and Answers. KFF. Retrieved May 21, 2022, from https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/

Taylor, J. Y., Caldwell, C. H., Baser, R. E., Matusko, N., Faison, N., & Jackson, J. S. (2013). Classification and correlates of eating disorders among blacks: Findings from the National Survey of American Life. Journal of Health Care for the Poor and Underserved, 24(1), 289–310. https://doi.org/10.1353/hpu.2013.0027

Taylor, J. Y., Caldwell, C. H., Baser, R. E., Faison, N., & Jackson, J. S. (2007). Prevalence of eating disorders among blacks in the National Survey of American Life. International Journal of Eating Disorders, 40(S3). https://doi.org/10.1002/eat.20451

Gray, A. (2020, January 2). Yes, black girls get eating disorders. Shondaland. Retrieved March 2, 2022, from https://www.shondaland.com/live/body/a30171323/black-girls-eating-disorders/