There is a commonly held view that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that cause severe disturbances to a person’s eating behaviors. Obsessions with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. More studies are being done to increase data amongst Black women regarding this subject.
Anorexia
Anorexia nervosa is an eating disorder that makes people lose more weight than is considered healthy for their age and height.
Persons with this disorder may have an intense fear of weight gain, even when they are underweight. They may diet or exercise too much or use other ways to lose weight.
Bulimia
Bulimia is an illness in which a person has regular episodes of eating a very large amount of food (bingeing) and feels a loss of control over eating. The person then uses different ways, such as vomiting or laxatives (purging), to prevent weight gain.
Many people with bulimia also have anorexia nervosa.
In a 2011 study, it was found that Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior, such as binging and purging according to NEDA (National Eating Disorders Association).
Binge-Eating Disorder
Binge eating is an eating disorder in which a person regularly eats unusually large amounts of food. During binge eating, the person also feels a loss of control and is not able to stop eating.
There is a general belief that eating disorders are a young, white woman’s problem, however, there is increasing evidence that women of color, particularly Black girls and women, also suffer from eating disorders. The organization NEDA cites that exact statistics on eating disorders among women of color are not available. According to their website:
Due to our historically biased view that eating disorders only affect white women, relatively little research has been conducted utilizing participants from racial and ethnic minority groups.
In spite of these factors, reports of eating disorders among women of color are on the rise. Some of this gain may simply reflect an increase in the reporting of these problems rather than actual increases. Three factors affect the rate of reporting among minority women: underreporting of problems by the individual, under and misdiagnosing on the part of the treatment provider, and cultural bias of Diagnostic and Statistical Manual-IV criteria for eating disorders.
Following are a few statistics from prior research:
A national study of African American and Caribbean Blacks conducted by The National Survey of American Life (NSAL) was the first to examine eating disorders with Blacks included in the sample group, according to a Psychology Today article. Findings from the survey showed binge eating disorder was the most prevalent among Blacks, with an older onset age. According to the author, “This older age of onset may reflect less of a concern for smaller body size and may represent more of a reaction to stress. Lower incomes and stress due to racism may have an effect on the drive to binge as a coping mechanism.”
Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. These disorders affect both genders, although rates among women are 2½ times greater than among men. Like women who have eating disorders, men also have a distorted sense of body image. For example, men may have muscle dysmorphia, a type of disorder marked by an extreme concern with becoming more muscular.
Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Researchers are using the latest technology and science to better understand eating disorders.
One approach involves the study of human genes. Eating disorders run in families. Researchers are working to identify DNA variations that are linked to the increased risk of developing eating disorders.
Brain imaging studies are also providing a better understanding of eating disorders. For example, researchers have found differences in patterns of brain activity in women with eating disorders in comparison with healthy women. This kind of research can help guide the development of new means of diagnosis and treatment of eating disorders.
Anorexia nervosa
People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, and eat very small quantities of only certain foods. Anorexia nervosa has the highest mortality rate of any mental disorder. While many young women and men with this disorder die from complications associated with starvation, others die of suicide. In women, suicide is much more common in those with anorexia than with most other mental disorders.
Symptoms include:
Other symptoms may develop over time, including:
Bulimia nervosa
People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike anorexia nervosa, people with bulimia nervosa usually maintain what is considered a healthy or relatively normal weight.
In the U.S., binge eating is the most common eating disorder. More women than men have it. Women are affected as young adults while men are affected in middle age.
Symptoms include:
Binge-eating disorder (BED)
People with binge-eating disorder lose control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.
Symptoms include:
Anorexia
Tests should be done to help find the cause of weight loss, or see what damage the weight loss has caused. Many of these tests will be repeated over time to monitor the person.
These tests may include:
Bulimia
A dental exam may show cavities or gum infections (such as gingivitis). The enamel of the teeth may be worn away or pitted because of too much exposure to the acid in vomit.
A physical exam may also show:
Blood tests may show an electrolyte imbalance (such as hypokalemia) or dehydration.
Binge-Eating Disorder
The health care provider will perform a physical exam and ask about your eating patterns and symptoms.
Blood tests may be done.
Anorexia
The biggest challenge in treating anorexia nervosa is helping the person recognize that they have an illness. Most people with anorexia deny that they have an eating disorder. People often enter treatment only when their condition is serious.
Goals of treatment are to restore normal body weight and eating habits. A weight gain of 1 to 3 pounds per week is considered a safe goal.
Different programs have been designed to treat anorexia. Sometimes the person can gain weight by:
Many patients start with a short hospital stay and follow-up with a day treatment program.
A longer hospital stay may be needed if:
Care providers who are usually involved in these programs include:
Treatment is often very difficult. Patients and their families must work hard. Many therapies may be tried until the patient overcomes this disorder.
Patients may drop out of programs if they have unrealistic hopes of being “cured” with therapy alone.
Different kinds of talk therapy are used to treat people with anorexia:
