January 28, 2023

Eating Disorders and Diversity: People of All Races Go Through Eating Disorders

Research on what demographic is most likely to have an eating disorder shows us that eating disorders do not discriminate. Although some groups aren’t as heavily represented in research or treatment, people of all races, ethnicities, genders, ages, and sexual orientations live with eating disorders all over the world. 

On top of that, anorexia nervosa isn’t the only type of eating disorder, and not everyone who lives with an eating disorder is thin.

It’s time to challenge the idea that eating disorders are only a “young white woman’s disease.”

This doesn’t mean that race and other identities have no place in conversations about eating disorders. Racism and other types of discrimination can and do leave some groups more vulnerable to living with eating disorders without access to treatment, and this is critical to pay attention to.

Today, we’ll talk about how eating disorders impact people of all identities, and what you can do to get support if you don’t see yourself reflected in the dialogue around eating disorders.

Race and eating disorders: What culture has the highest rate of eating disorders?

Early research disseminated the mistaken idea that white women have a higher risk for developing eating disorders than Black, Hispanic, or Asian women. But newer research has found that this is actually untrue.

One large study followed over 1000 women for a period of 3 years to measure dysfunctional eating attitudes and behaviors (risk factors for eating disorders) and eating disorder symptoms. The young women were Americans from different racial backgrounds (white, Black, Asian, and Hispanic).

The study found no significant difference in eating disorder prevalence in the different groups. In other words, every race was equally as likely to have an eating disorder as others.

They did find differences in two of the 13 risk factors for eating disorders: thin-ideal and body mass index. 

Asian American women were more likely to idealize thinness than the other groups. Black women were much less likely to idealize thinness, but also had a higher average body mass index (BMI) – which is associated with more severe eating disorder symptoms. 

But even though Black women had some cultural factors that may protect against eating disorders (such as not valuing extremely thin bodies), they had the same overall rate of eating disorders.

What this study shows us is that different racial groups share many commonalities when it comes to eating disorder risk. Every group has the same overall likelihood of developing eating disorders, and we also, for the most part, share the same risk factors. People in BIPOC communities have the added risk factor of stress brought on by racism and societal oppression.

Here are some other findings from research that make it clear that people from BIPOC communities experience eating disorders as frequently as white women do.
  • Black teens are up to 50% more likely than their white counterparts to binge and purge (bulimic behaviors).
  • Hispanic people are more likely to have bulimia nervosa than Whites.
  • Some research has shown that non-White youth are more likely to have binge eating disorder.
  • Native American youth are much more likely than other racial groups to be attempting weight loss. One study found that almost half of Native American youth were currently trying to lose weight.
  • Asian American college students were found to have higher levels of body dissatisfaction, food restriction, and purging than both white and non-Asian BIPOC peers.

More and more, we’re learning that when we compare rates of eating disorders by race, there’s not as big of a gap as the media leads us to believe – in fact, the research suggests that there is no gap at all.  

Eating disorders in the LGBTQ+ community

Not only are people with eating disorders not always white – they’re also not always women, straight, or cisgender. People in the LGTBQ+ community are disproportionately affected by eating disorders.

Research has found that:

  • Gay men are 12 times more likely to report purging – and 7 times more likely to report binge eating – than straight men.
  • Transgender students are 4 times more likely to have an eating disorder than their cisgender classmates.
  • Over 60% of LGBTQ+ youth reported engaging in at least one disordered eating behavior.
  • Over a third of transgender people report using disordered eating to modify their bodies without using hormones.
  • Half of LGBTQ+ youth have experienced weight-based bullying or victimization, which then leads to unhealthy behaviors like binge eating.
  • The body dysmorphia that many transgender people experience is often linked with a higher rate of eating disorders.

The research is clear that not only do people in the LGBTQ+ community face eating disorders, but they experience them at even higher rates than the heterosexual or cisgender population.

Marginalization in eating disorder treatment

So we know, from the research, that eating disorders don’t discriminate – people of all races and gender identities live with eating disorders. 

Where we do, unfortunately, see big differences between groups is in the area of eating disorder assessment and treatment.

Research shows that BIPOC individuals are only about half as likely as white people to receive a diagnosis or treatment for their eating disorder. 

They are less likely to seek treatment due to a variety of different factors, but they’re also less likely than white people to be identified by health professionals as needing treatment. Studies have found that Black and Hispanic people are significantly less likely to be asked about eating disorder behaviors than their white peers.

The same goes for the LGBTQ+ community. Experts say that although LGBTQ+ youth experience eating disorders at higher rates, they’re underdiagnosed. In a recent survey conducted by The Trevor Project, around a third of respondents said they suspected they had an eating disorder, but they’d never been diagnosed.

Non-white people, as well as people in the LGBTQ+ community, are getting overlooked when it comes to eating disorder treatment. Black women, in particular, are falling through the cracks.

This is a serious problem. Eating disorders are among the most fatal psychiatric disorders, and it’s dangerous for people who don’t fit the outdated and stereotypical “wealthy white female” picture of eating disorders to be left without the treatment they need.

Teen eating disorder treatment in Bellevue, WA

Moving forward, and ensuring that everyone who has an eating disorder receives treatment, will require systemic change. 

In the meantime, our clinical team at Cadence Therapy is committed to practicing cultural humility. We have a deep understanding that there is no one way a teen with an eating disorder looks – young people with eating disorders can be of any gender, race, sexual orientation, weight, and body shape.

If you (or your child) think you may need support for your eating disorder, we’re here for you. Every person with an eating disorder deserves treatment, and we encourage you to reach out. We’ll make sure you don’t fall through the cracks.

Get started by filling out our interest form, and we’ll get in touch with you.

Resources for BIPOC with eating disorders and other mental health challenges:

ANAD, free online support groups for BIPOC https://anad.org/get-help/about-our-support-groups/

National Alliance on Mental Illness (NAMI) San Francisco’s online virtual support groups for BIPOC: https://www.namisf.org/bipoc-supportgroups

Nalgona Positivity Pride: body positivity for people of color https://www.nalgonapositivitypride.com/

Not All Black Girls Know How to Eat by Stephanie Covington Armstrong

Project Heal, BIPOC Treatment Equity Project https://www.theprojectheal.org/bipoc-tep-1

The National Eating Disorder Foundation: Virtual Support Group for BIPOC https://eatingdisorderfoundation.org/event/virtual-bipoc-support-group-2/

Resources for LGBTQ+ youth with eating disorders:

ANAD: LGBTQ+ Eating Disorder Support Group https://anad.org/get-help/about-our-support-groups/

Fed Up Collective https://fedupcollective.org/

Project Heal, LGBTQ+ Treatment Equity Project https://www.theprojectheal.org/lgbtqtep-1

My Thinning Years: Starving the Gay Within by Jon Derek Croteau

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