When the question of weight loss behaviors and eating disorders among different ethnic groups arises, most will acknowledge that eating problems affect a wider population than just young white women. Some research seems to suggest that the prevalence of eating disorders among other ethnicities is closing the gap with the rates among whites.
Is our image-conscious culture having a greater and greater effect on people of color, drawing them into image-driven disordered eating more often? How does ethnicity affect weight control behaviors? Here, we narrow the question to the differences between black women and white women.
Weight Loss Behaviors Among Black Women: Less Body Consciousness
Young black women seem to be less likely than white women to develop eating disorders involving food restriction, such as anorexia nervosa. Instead, the bias of black women appears to be toward eating disorders involving binge eating. Though binge eaters have concerns about weight gain and body shape, they do not have the "do-or-die" attitude toward weight loss found among those with anorexia.
Also, consider the results of a study using the Eating Disorders Inventory (EDI). The EDI includes 8 subscale scores corresponding to common traits of those with eating disorders:
- Drive for thinness
- Ineffectiveness (low self-esteem)
- Bulimia
- Perfectionism
- Body dissatisfaction
- Interpersonal distrust
- Interoceptive awareness (perception of internal sensations)
- Maturity fears (fear of growing up)
Black girls aged 11 to 14 scored higher than their white counterparts on 6 of the 8 subscales. In an interesting twist, the two subscales on which blacks did not score higher than whites were Drive for Thinness and Body Dissatisfaction, the two subscales that measure body image most directly. The other subscales are strongly linked with disordered eating, but a person can score high on them without body image concerns.
Confirming Differences in Weight Loss Behaviors and Body Image Between Black and White Women
A 2008 study specifically examined adolescent girls (and boys) to determine how their eating and dieting changed over time. Black girls were the least likely to engage in weight control behaviors (compared to whites and Hispanics). The authors point to prior research results suggesting that black women have more flexibility in their beliefs about what is beautiful. This result seems to line up with the EDI study above: Body image issues aren't as prevalent among black women.
The researchers' ultimate question, though, was whether the gap between weight control behaviors (essentially, controlling the body's shape) in black women and white women is closing. The study examined the rates of weight control behaviors among adolescent women of different ethnicities over time. The researchers were surprised to find that black women were not catching up to white women in the frequency of these behaviors.
This begins to cast doubt on the common thought that the influence of media and advertising is causing body image beliefs among women in the black community to conform to those of whites.
What Can We Say About Eating Disorders in Black Women?
Do black women have an "immunity" from body image problems and eating disorders? Far from it. Anorexia, bulimia, and binge-eating disorder, along with other eating disorders that don't fit these definitions, can affect anyone. And while no single study is conclusive, persistent difference in weight control behaviors between ethnicities over time in the above study suggests that eating disorder healthcare providers may eventually have better knowledge of how to tailor evaluation and treatment to the individual, taking ethnicity into consideration.
To do this, future research should point toward establishing consistent traits and trends. With this knowledge, we can answer crucial questions. For example, are current tests for disordered eating (like the EDI, the EAT-26, and the SCOFF screening) ethnically neutral? If not, they will be inaccurate tools for assessment of eating disorders among people of color.
And just as assessment tools must change when cultural bias is found, so must treatment strategies. Perhaps education on healthy body image, a common element of eating disorder treatment, isn't as effective among black women. We need to know, and soon. Black women may not be gaining ground on white women in weight control behaviors, but reports of eating disorders in both populations continue to rise.
Sources:
National Eating Disorders Association. "Research Results on Eating Disorders in Diverse Populations." 2006. Accessed 30 April 2008.
Chao YM, Pisetsky EM, Dierker LC, Dohm F, Rosselli F, May AM, Striegel-Moore RH. Ethnic differences in weight control practices among U.S. adolescents from 1995 to 2005. International Journal of Eating Disorders 41 (2008): 124-133.
Striegel-Moore RH, Schreiber GB, Lo A, Crawford P, Obarzanek E, Rodin J. (2000). Eating disorder symptoms in a cohort of 11 to 16-year-old black and white girls: The NHLBI growth and health study. International Journal of Eating Disorders 27 (2000): 49-66.
