Anorexia, bulimia becoming 'equal opportunity disorders'

Black Issues in Higher Education, April 21, 2005

MONTGOMERY, ALA.

Liza LeGrand's odyssey started with anorexia in her early 20s, eventually evolving to include classic binge and purge episodes. Before long, the five-foot-two-inch woman had dwindled down to 70 pounds.

Now 36 and living in Orlando, Fla., LeGrand continues to struggle with her eating disorder. But she says she at least understands it. And she now knows she's not the only minority woman to have such a problem.

LeGrand is a Puerto Rican dealing with what many believe is a "White woman's" problem.

The common perception is that eating disorders afflict only White women, especially those in the upper- and middle-classes. While that demographic does constitute the most reported cases, specialists believe all socioeconomic and ethnic groups are at risk.

"For so long there was the belief that eating disorders only involved young White women," says Dr. Gayle Brooks, a Black psychologist specializing in eating disorders at the Renfrew Center in south Florida where LeGrand was treated. "What they saw were exclusively White women with the problem."

Black and Hispanic women were thought to be less likely to develop anorexia and bulimia because more voluptuous physiques are generally considered attractive within their ethnic groups. A study in the Journal of Counseling in Psychology in 2001 found that African Americans were more accepting of larger body shapes and less concerned with dieting.

But Dr. Laurie Mintz, an associate professor of counseling psychology at the University of Missouri-Columbia, says adoption of "Western values concerning attractiveness and thinness may increase minority women's risk for the development of eating disorders."

Research over the last decade has found these eating disorders among minority women and lower-income women, she says. Increasingly, anorexia and bulimia may be becoming "an equal opportunity disorder."

According to the National Eating Disorders Association, there are no reliable statistics on the prevalence of eating disorders among minorities, but diverse communities are under-represented in the research.

Brooks suggested several reasons for the invisibility of minority women suffering from eating disorders:

* Because minority and poor women don't fit the profile, doctors and therapists often fail to assess them properly for eating disorders.

* Education efforts haven't been directed toward ethnic groups, so family and friends often miss the early signs.

* For some poor women, it may be hard to get adequate treatment.

Dr. Stephen B. Thomas, director of the Center for Minority Health at the University of Pittsburgh, says he has met only one African-American with anorexia.

"Other than the color of her skin, she matched her middle-class White counterparts when it came to the important factors associated with the disease," he says.

He is concerned that these eating problems may increase as health agencies target overweight minorities. Two-thirds of Americans are overweight or obese, and the percentages are higher among Blacks and Hispanics.

"As the nation becomes focused on obesity as a national obsession, we must be aware of unintended consequences," says Thomas. "We do not want to create conditions that contribute to eating disorders in our zeal to address obesity."