Did you know that eating disorders can affect different communities of people of any age, race, gender, or sexual orientation? 

Despite increased awareness of eating disorders in the United States, the different communities of people who have eating disorders continue to be widely misunderstood and excessively stereotyped, leaving out the majority of those who struggle. 

When/if they seek clinical attention for an eating disorder, men, people of color, and members of the LGBTQ+ community are less likely to receive a diagnosis and more likely to encounter severe barriers to receiving treatment despite signs and symptoms of eating disorders being similar to other communities.

The Statistics Behind Communities Affected by ED’s

• Teenagers of color are 50% more likely than those of white teenagers to engage in bulimic behaviors including binging and purging.
• Hispanics were substantially more likely than their non-Hispanic peers to experience bulimia nervosa in a study of adolescents. Researchers also noted a higher prevalence of binge eating disorder among all minority groups.
• Asian, Black, Hispanic, and Caucasian youth all said they were attempting to lose weight at similar rates, while among Native American adolescents, 48.1% were trying to lose weight.
• Because of the particular difficulties the LGBTQ+ community face, they are significantly more likely to develop eating disorders during their lifetime. Challenges for this community may include family rejection, peer bullying, coming out anxiety, gender dysphoria, and other issues.
• Although it is believed that gay men make up only 5% of all males, 42% of men with eating disorders identify as gay.
• Gay men were seven times more likely than heterosexual men to report bingeing and twelve times more likely to report purging.
• Gay and bisexual men showed a considerably greater prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any other subclinical eating disorder compared to heterosexual men.
• About twice as many women who identified as lesbian, bisexual, or primarily heterosexual reported binge eating at least once per month in the last year.

Eating Disorders in LGBTQ+ Communities

People from the LGBTQ+ community are often discouraged from getting help because of hurtful stereotypes. Common barriers to getting help within this community include:

• Lack of family and friend support
• Lack of culturally competent treatment that addresses the complexity of particular sexuality and gender identity issues
• Lack of eating disorder education among LGBTQ+ communities
• Lack of resources for providers, who are in a position to recognize and intervene

Additionally, members of the LGTBQ+ community face unique risk factors that might make it difficult for them to get the help and assistance they need. These unique risk factors may or may not include:

• Fear of rejection from friends, family, and coworkers
• Violence, and post-traumatic stress disorder (which research shows increases vulnerability to an eating disorder)
• Discrimination on the basis of sexual orientation or gender identity
• Bullying because of one’s sexual orientation and/or gender identity.¹

Eating Disorders in Latino Communities

Love is typically shown through food in many cultures, particularly Latinx ones, where males are raised to earn a living and provide for the family while women are raised to learn how to cook and take care of the home. Women who learn to prioritize the needs of others and refrain from asking for help may feel isolated as a result of this division, which makes obtaining care challenging in this situation. In other words, people in the Latino community may feel guilt or shame for reaching out for help in terms of eating disorder recovery. 

According to research, Latinas experience eating disorders and body image issues at rates equal to or higher than non-Latina whites.¹ Other studies have shown that Latina women may struggle with conflicting cultural expectations, as larger bodies are typically praised within their own families.¹ This, however, runs contrary to the Caucasian culture, which praises a thinner body ideal.

Eating Disorders in Asian Communities

Asian Americans and Pacific Islanders (AAPI) frequently live in tight-knit neighborhoods where people avoid displaying signs of weakness and negative emotions. As a result, the stigma that disordered eating is a sign of “weakness” may cause it to be ignored. People in this community frequently come from homes that place a high value on accomplishment and high parental expectations. 

These households also tend to have high rates of perfectionism, which is actually a risk factor for developing anorexia nervosa.¹ In this group, admitting that one needs help would be viewed as an act of weakness and cause shame in families, which would further prevent access to care and treatment, similar to the Latino community.

Eating Disorders in BIPOC Communities

*BIPOC stands for Black, Indigenous, and People of Color. 

Less than 6% of people with eating disorders are medically diagnosed as “underweight” and BIPOC with eating disorders are half as likely to be diagnosed or to receive treatment.²

Along with this lack of treatment, there is also racism and a lack of access to food. This complex issue is broken down as follows: Black women have historically had higher rates of poverty than white women due to institutional racism.

Poverty makes it more difficult to obtain healthcare, which can make obtaining an eating disorder diagnosis difficult and expensive. Furthermore, poverty frequently results in limited food access, which can be a risk factor for developing an eating disorder.

Eating Disorders in Food-Insecure Communities

According to growing research, there is a link between food insecurity and eating disorders. One study showed that people living with high levels of food insecurity report higher levels of binge eating, a higher likelihood of having any type of eating disorder, dietary restraint for any reason (e.g., avoiding a food group or types of food), weight self-stigma, and high levels of worry.³ 

Additionally, adolescents in households experiencing food insecurity report higher rates of compensatory behaviors, including laxative/diuretic use, fasting and skipping meals to lose weight.⁴ 

According to research, the relationship between food insecurity and risk of having an ED is found to be direct. This means that the more food insecure the household is, the greater the risk of having an ED is. Food consumption is likely to rise significantly during times of abundance or availability, but it declines during times of shortage (or famine).

Statistics on Dietetic Students and Eating Disorders

Lastly, being in the dietetic community does not protect you from eating disorders. In past and present research, these are some of the findings related to the dietetic community and eating disorders:

• In one study conducted in 1992, students taking dietetic and food science courses scored higher in binge eating behaviors than students from other non-nutrition majors.⁵
• In another study conducted in 2015, it was discovered that nutrition majors had higher binge-eating tendencies than students in other courses.⁶
• When compared to other students, nutrition students tended to restrict their food intake in order to control their weight.⁷
• Female nutrition students exhibited greater eating restraint than non-nutrition students.⁸
• In a review, studies showed that many nutrition students felt there was an image associated with their success as a dietitian.⁸ And that image was thin.

One theory for the increased prevalence of eating disorders among the dietetic communities is that dietetic students and practitioners often feel the societal pressures of needing to look the part. When entering the field of dietetics, the public assumes we represent the picture of health. Unfortunately, in or society, health is also mistakenly associated with thinness.

To learn more about eating disorders, check out our resources page or for further assistance in your recovery journey, visit our services page!

If you or a loved one are coping with an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237 (call or text).

References

1. Eating disorders in minorities & marginalized groups. (2019, March 6). Center For Discovery.
2. Giachin, G. (2016, May 8). Eating disorder statistics. National Association of Anorexia Nervosa and Associated Disorders.
3. Becker, C. B., Middlemass, K., Taylor, B., Johnson, C., & Gomez, F. (2017). Food insecurity and eating disorder pathology. The International Journal of Eating Disorders, 50(9), 1031–1040.
4. Hooper, L., Telke, S., Larson, N., Mason, S. M., & Neumark-Sztainer, D. (2020). Household food insecurity: associations with disordered eating behaviors and overweight in a population-based sample of adolescents. Public Health Nutrition, 23(17), 3126–3135.
5. Reinstein, N., Koszewski, W. M., Chamberlin, B., & Smith-Johnson, C. (1992). Prevalence of eating disorders among dietetics students: does nutrition education make a difference? Journal of the American Dietetic Association, 92(8), 949–953.
6. Poínhos, R., Alves, D., Vieira, E., Pinhão, S., Oliveira, B. M. P. M., & Correia, F. (2015). Eating behavior among undergraduate students. Comparing nutrition students with other courses. Appetite, 84, 28–33.
7. Korinth, A., Schiess, S., & Westenhoefer, J. (2010). Eating behavior and eating disorders in students of nutrition sciences. Public Health Nutrition, 13(1), 32–37.
8. Mahn, H. M., & Lordly, D. (2015). A review of eating disorders and disordered eating amongst nutrition students and dietetic professionals. Revue Canadienne de La Pratique et de La Recherche En Dietetique [Canadian Journal of Dietetic Practice and Research], 76(1), 38–43.