Is the Incidence of Eating Pathology and Intense Body Dissatisfaction in poorer communities of color comparable to national incidence?

Abstract

Abstract Background: Communities of color have been under-assessed and under-diagnosed with eating disorders. Most of the previous research on BIPOC communities has focused mainly on eating pathology as it relates to food insecurity. The purpose of this study was to explore whether the incidence of eating pathology and intense body dissatisfaction in poorer communities of color was comparable to the incidence reported by the National Institute of Mental Health and National Eating Disorder Association. The data outcomes may be relevant to community based mental health clinics and their partners as it will potentially highlight gaps in research, diagnostic assessment, and treatment interventions specific to eating disorders in marginalized communities. Methods: The data was collected from 309 individuals seeking mental health treatment in a community based mental health clinic in East Harlem NYC. Two separate assessments were utilized. The first assessment was conducted at intake within the comprehensive psychosocial assessment. It was a self-reported measure that assessed frequencies of 5 types of eating pathology: 1.) restricting, 2.) restricting/binging 3.) restricting/purging, 4.) binge/purging, and 5.) binging. Body and Weight Attitude Likert assessment scale, a 14-item measure was created based on 5 sub-scales: 1.) income 2.) restricting eating and obsessive thought behavior 3.) body dissatisfaction 4.) binge-eating and compensatory behavior 5.) emotional distress. Results: This is the first study to investigate rates of eating pathology and attitudes around body image and weight in a poorer community with the majority of the community identifying as people of color. What we found was high rates of body dissatisfaction and high incidence of eating pathology which is not only comparable to the NIMH and NEDA’s data for a white population but is higher than what the current data supports for any racialized group. Our data also shows higher rates of eating disorder diagnosis, particularly for AN, AAN, and EDNOS than what is supported in either NIMH and NEDA for any racialized group We discovered the incidence of frequency of restricting food was highest in the Black and mixed-Race participants. Black participants had the highest rate of diagnosis of an eating disorder of restricting type, which is much higher than the national incidence. Body dissatisfaction is the most notable risk factor in the development of eating disorders. The mixed-race group (n=97) rated highest on intensity of body dissatisfaction. This study highlights the need for further investigation, so we don’t perpetuate the neglect of these communities in both mental and medical health care.