Sophia Merine
Script:
The perception of eating disorders affecting young, skinny, white women has made it harder for ethnic minorities to seek treatment for eating disorders. Ethnic minorities, specifically in North Carolina, are less likely to seek treatment for their eating disorders because of the stigma surrounding eating disorders and the influence that Western culture has on what is a desirable shape. Societal pressure, the stigma surrounding eating disorders, and disparities in healthcare have affected access to receiving eating disorder treatment.
Eating disorders are illnesses that cause disturbances in eating patterns as well as the thoughts and emotions that accompany these behaviors. Society puts pressure on people to have very unrealistic body types encouraging thin and muscular appearances.
Eating disorder symptoms exist at higher rates in ethnic minorities (Rogers et al, 2018, p. 90). Ethnic minorities reported not knowing where to seek help and not wanting to be labeled as having an eating disorder and were less likely to be referred for treatment.
NEDA published several statistics on eating disorders that reveal disparities in treatment. “44% [of clinicians] identified the white woman’s behavior as problematic; 41% identified the Hispanic woman’s behavior as problematic, and only 17% identified the black woman’s behavior as problematic. The clinicians were also less likely to recommend that the African-American woman should receive professional help” (NEDA, 2021). Black women are considered to have a higher pain tolerance and are not taken seriously when they seek help.
In 2015, North Carolina schools reported sixty-four elementary students, 114 middle school students, and 210 high school students had an eating disorder that required action from the school (NCLEG, 2017, pg. 2). Seventeen residents of North Carolina died due to an eating disorder. In 2016, ninety-two residents were hospitalized. No data is found on how many residents have not been formally diagnosed with an eating disorder or are receiving treatment for an eating disorder. Few eating disorder treatment centers accept insurance (NCLEG, 2017, pg. 2). There is less availability of inpatient psychiatric beds for eating disorders due to the number of psychiatric patients. Several recommendations for increasing awareness for eating disorders and distributing information on eating disorders include raising awareness of NEDA toolkits, sharing information on eating disorder myths, encouraging family meals, and focusing on healthy eating.
Barriers to treatment need to be addressed such as the stigma surrounding eating disorders and healthcare disparities. Educating more people about eating disorders can help people spot warning signs and awareness of eating disorders. It is important to understand how to help patients within their own cultural context which includes exploring the patient’s worldview and different cultural norms.
Explication:
How Eating Disorders Impact Minorities in North Carolina
Eating disorders have impacted varying demographics for decades, but the diagnosis and treatment of eating disorders have grown to have a different outcome in ethnic minorities than in white populations. Stereotypically, eating disorders are associated with affecting young, skinny, white women. This perception has made it harder for ethnic minorities to seek treatment for eating disorders, because of the medical stigma surrounding them. The belief that eating disorders only impact young, white women is harmful and understanding cultural circumstances can have a positive outcome on treatment. Ethnic minorities are therefore less likely to seek help for eating disorders as they are less likely to be diagnosed and helped. My goal for this presentation is to showcase the disparities between white patients seeking treatment and minorities in seeking treatment, and how these disparities can be addressed and eliminated. The purpose of my paper is to answer the question: Why are ethnic minorities less likely to seek eating disorder treatment yet more likely to develop symptoms than white individuals in North Carolina? This question is important to me because I found that my experience when receiving eating disorder treatment was very different than that of my white counterparts. I felt as though I was not taken seriously. My initial assumptions surrounding my topic are that minorities have a harder time receiving an eating disorder diagnosis and do not seek treatment. Looking at several studies that have been conducted about this topic and how eating disorders are treated based on the culture of the patient, I will evaluate data that provides recommendations on treatment for ethnic minorities. Ethnic minorities, specifically in North Carolina, are less likely to seek treatment for their eating disorders because of the stigma surrounding eating disorders and the influence that Western culture has on what is considered a desirable shape. This societal pressure in addition to the stigma surrounding eating disorders, and disparities in healthcare have affected access to receiving eating disorder treatment.
Eating disorders are illnesses that cause disturbances in eating patterns as well as the thoughts and emotions that accompany these behaviors. Eating disorders are caused by genetic, environmental, biological, and psychological factors. People who suffer from eating disorders have a preoccupation with thoughts about food, weight, calories, and their appearance. The most common eating disorders are anorexia nervosa, bulimia, and binge-eating disorder. Anorexia nervosa is characterized by very low body weight and a fear of gaining weight. Bulimia nervosa is characterized by binge eating episodes followed by thoughts of shame and purging behaviors following these binging episodes. Binge eating disorder is characterized by episodes of binging that are not followed by purging.
Society puts pressure on people to have very unrealistic body types encouraging thin and muscular appearances which are perpetuated by the media and family members and friends. This along with the emphasis on Eurocentric beauty standards contributes to disordered eating.
Almost two percent of the American population was diagnosed with an eating disorder in 1990 (Kempa & Jones Thomas, 2000, p. 17). Eating disorders are often associated with young, white women. This association has led to many of the screening, diagnostic, and eating disorder assessment tools being developed among the white, female demographic (Rogers et al, 2018, p. 90). Eating disorders affect people of all ethnic and racial backgrounds. Recent studies and research have aimed to include more culturally sensitive diagnostic tools that will make it easier to identify and treat eating disorders in ethnic minorities.
In ethnic minorities, eating disorder symptoms exist at high rates (Rogers et al, 2018, p. 90). The stigma surrounding eating disorders differs with each cultural group. People of Asian descent have the highest rate of eating disorder behaviors compared to their Hispanic, White, and Black counterparts (Rogers et al, 2018, p. 90). The desirable figure for Asian women to have in specific is a very thin body, and they face a lot of pressure to have a slim figure. Hispanic and Latino populations suffer from binge eating disorder (BED) at higher rates than other ethnic groups. Latinos engage in fewer exercise behaviors, dieting behaviors and overall have fewer concerns about their weight. Later in life, this often leads to a cycle of Latinos being more afraid of weight gain because of binge eating and following these episodes by dieting. Studies on eating disorders in Black Americans are varied. Among black men, they reported higher body satisfaction and less fear of weight gain (Rogers et al, 2018, p. 90). In a second study, black boys reported overeating and unhealthy weight control behaviors (Rogers et al, 2018, p. 90). Black girls reported fewer dieting behaviors in comparison to their Asian, White, and Latino counterparts (Rogers et al, 2018, p. 90).
An important term that was defined by Sarmila Sinha and Nasir Warfa in their study of treatment of eating disorders in women of different ethnicities is acculturation, “Acculturation has been defined as the process of cultural and psychological change that takes place as a result of contact between cultural groups and their individual members. There is evidence to suggest that there may be a relationship between the level of acculturation and treatment” (Sinha & Warfa, 2013, p. 295). Less accultured groups are less likely to seek treatment than more accultured groups. The results of their study showed that ethnic minorities are less likely than their white counterparts to seek and receive eating disorder treatment. White Americans reported feelings of shame and thinking that they need to be able to help themselves thus carry the burden on their own. Ethnic minorities reported not knowing where to seek help and not wanting to be labeled of having an eating disorder (Sinha & Warfa, 2013, p. 296). Ethnic minorities were less likely to be referred for treatment and many of these groups contacted inpatient and outpatient centers, but still did not receive help. The ethnic background of patients played a large role in whether they were recommended for treatment or not.
The National Eating Disorder Association or NEDA published several statistics on eating disorders that reveal disparities in treatment. “When presented with identical case studies demonstrating disordered eating symptoms in white, Hispanic and African-American women, clinicians were asked to identify if the woman’s eating behavior was problematic. 44% identified the white woman’s behavior as problematic; 41% identified the Hispanic woman’s behavior as problematic, and only 17% identified the black woman’s behavior as problematic. The clinicians were also less likely to recommend that the African-American woman should receive professional help” (NEDA, 2021). Black women are often wrongly considered to have a higher pain tolerance and thus are not taken seriously when they seek help. This is extremely dangerous because it limits the amount of help that black women receive and perpetuates a racist cycle.
The following data comes from the Joint Legislative Oversight Committee on Health and Human Services by the North Carolina Department of Health and Human Services. In 2015, North Carolina schools reported sixty-four elementary students, 114 middle school students, and 210 high school students had an eating disorder that required action from the school (NCLEG, 2017, pg. 2). Seventeen residents of North Carolina died due to an eating disorder. In 2016, ninety-two residents were hospitalized due to an eating disorder. No data is found on how many residents have not been formally diagnosed with an eating disorder or are receiving treatment for an eating disorder (NCLEG, 2017, pg. 2). There are several barriers to treatment in North Carolina. Few eating disorder treatment centers accept Medicaid, Medicare, or Tricare (NCLEG, 2017, pg. 2). There is less availability of inpatient psychiatric beds for eating disorders due to the number of psychiatric patients, so patients with eating disorders have longer inpatient waiting times. The document also provides recommendations for increasing awareness for eating disorders and distributing information on eating disorders. Several of these strategies include raising awareness of NEDA toolkits, sharing information on eating disorder myths, encouraging family meals, and focusing on healthy eating.
Barriers to treatment need to be addressed such as the stigma surrounding eating disorders and healthcare disparities. Educating more people about eating disorders can help people spot warning signs and awareness of eating disorders. It is important to understand how to help patients within their own cultural context which includes exploring the patient’s worldview and different cultural norms.
References
Acle, A., Cook, B. J., Siegfried, N., & Beasley, T. (2021). Cultural considerations in the treatment of eating disorders among racial/ethnic minorities: a review. Journal of Cross-Cultural Psychology, 52(5), 468–488. https://doi.org/10.1177/00220221211017664.
Cohn L., Murray S. B., Walen A., & Wooldridge T. (2016). Including the excluded: males and gender minorities in eating disorder prevention. Taylor & Francis Online, 24(1), 114-120, DOI: 10.1080/10640266.2015.1118958.
North Carolina Department of Health and Human Services. (2017). Legislative study on eating disorders. North Carolina General Assembly. 57(11E.11), 1-7, https://www.ncleg.gov/documentsites/committees/JLOCHHS/Handouts%20and%20Minutes%20by%20Interim/2017-18%20Interim%20JLOC-HHS%20Handouts/Reports%20to%20JLOC-HHS/November%202017/SL%202017-57%20Sec%2011E.11%20DHHS-DPH%20Eating%20Disorder%20Study%20Final.pdf.
Rodgers, R.F., Berry, R., & Franko, D.L. (2018). Eating disorders in ethnic minorities: an update. Curr Psychiatry Rep 20, 90. https://doi.org/10.1007/s11920-018-0938-3.
Sinha S., & Warfa N. (2013). Treatment of eating disorders among ethnic minorities in western settings: a systematic review. Psychiatria Danubia, 25(2), 295-299 http://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol25%20Suppl%202_no/dnb_vol25_noSuppl%202_295.pdf. (2021). Statistics & research on eating disorders. https://www.nationaleatingdisorders.org/statistics-research-eating-disorders.
Featured Image Source:
McArthur, C. (2016, February 8). It’s time to talk about eating disorders among BME women. Dazed. Retrieved October 26, 2021, from https://www.dazeddigital.com/artsandculture/article/29664/1/not-white-not-quite-eating-disorders-ethnic-minorities.