People of color, queer people, and trans people often suffer from complex issues of shame; this is not about a singular desire to be thin. After all, eating disorders, in general, are not about food or thinness. Causes for eating disorders go much deeper than a desire to be thin. These marginalized individuals describe not only insecurity about their weight, but a larger struggle for recognition. They feel directionless and isolated in a culture where it seems few individuals look like them and who genuinely understand their experiences.

  • Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior, such as binging and purging.
  • In a study of adolescents, researchers found that Hispanics were significantly more likely to suffer from bulimia nervosa than their non-Hispanic peers. The researchers also reported a trend towards a higher prevalence of binge eating disorder in all minority groups.
  • Asian, Black, Hispanic and Caucasian youth all said attempting to lose weight at similar rates, while among Native American adolescents, 48.1% were attempting weight loss.
  • LGBTQ individuals are much more likely to experience eating disorders throughout their lifetime, mainly because of the unique challenges they face
  • Gay males are thought to only represent 5% of the total male population, but among males who have eating disorders, 42% identify as gay.
  • Gay males were seven times more likely to report binging and 12 times more likely to report purging than heterosexual males.
  • Compared with heterosexual men, gay and bisexual men had a significantly higher prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder.
  • Females identified as lesbian, bisexual, or mostly heterosexual were about twice as likely to report binge eating at least once per month in the last year.

Causes for Eating Disorder in the Latino culture

In many cultures, specifically the Latino culture, love is often shown through food and women are raised to learn how to cook and take care of their household, which illustrates the importance of gender roles in the Latino community. Women are raised to stay in the home and take care of the family, the house and cook meals whereas men are raised to leave the house and make a living in order to support the family financially. This dichotomy creates sense isolation for women in the Latino community as they learn to put their own needs last, do not ask others for help, do not speak about their problems outside the home and often do not change their views. These can create many strong barriers to seeking treatment for eating disorders. Studies have shown that Latinas have eating disorders and body image concerns at rates comparable to or greater than non-Latina whites. Other research has demonstrated that Latina women may struggle with conflicting cultural expectation, where within their own families, larger bodies are generally celebrated. However, this conflicts with a Caucasian culture that promotes a thinner body ideal.

Causes for Eating Disorder in the Asian culture

Asian Americans and Pacific Islanders (AAPI) live in a close-knit community with their family being at their center. Signs of weakness and negative emotions are generally shunned upon, and as a result, any disordered eating pattern is usually pushed under the rug due to the stigma of being “weak.” In one study, Asian American participants came from higher income, achievement-orientated families and had an extreme concern about meeting parental expectations. This concern could be correlated with levels of perfectionism, which is an essential predictor of anorexia. If an individual in an Asian American family admits that he or she needs help for their eating disorder, their parents and other family members may experience fear and shame. They may assume that their son or daughter’s condition is a result of their poor parenting or a hereditary flaw.

Causes for Eating Disorder in the LGBTQ community

Stereotypes such as “gay men are all muscle or thin” or “all individuals with anorexia are malnourished” prevent people from seeking help. Other common barriers to treatment in the LGBTQ community include a lack of culturally-competent treatment, which addresses the complexity of unique sexuality and gender identity issues, lack of support from family and friends, and insufficient eating disorders education among LGBTQ+ resource providers who are in a position to detect and intervene. Additionally, individuals in the LGTBQ community experience unique risk factors that can cause them to face challenges when accessing treatment and support. These risk factors include the following:

• Fear of rejection or experience of rejections by friends, family, and co-workers
• Internalized negative messages/beliefs about oneself due to sexual orientation, non-normative gender expressions, or transgender identity
• Experiences of violence and post-traumatic stress disorder (PTSD), which research shows sharply increases vulnerability to an eating disorder
• Discrimination due to one’s sexual orientation and/or gender identity
• Being a victim of bullying due to one’s sexual orientation and/or gender identity
• Discordance between one’s biological sex and gender identity
• Inability to meet body image ideals within some LGBTQ cultural contexts

National Eating Disorder Awareness Week

This week is National Eating Disorder Awareness Week, which is sponsored by NEDA and is promoted throughout the United States for everyone who has been affected by an eating disorder, whether directly or indirectly. This year’s theme Come as You Are, highlights NEDA’s movement towards inclusivity in the greater eating disorder community and their goal of unifying the field of eating disorders. Navigating life after treatment for your eating disorder can be challenging, especially leaving a rigid treatment schedule and venturing out into the world of recovery. Individuals often will feel left out in society, which leaves them longing for inclusivity and the desire to be accepted; which is where eating disorder support groups are incredibly beneficial for the individual.

Source: National Eating Disorders Association (NEDA) Lee HY and Lock, J: Anorexia nervosa in Asian-American adolescents: do they differ from their non-Asian peers? International Journal of Eating Disorders 2007;40:227-231

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Eating Disorders and Minorities Part 1