Eating Disorders Without BordersEating Disorders Without Borders: The Rise of Eating Disorders Among Minorities, Males, and Developing Nations Sounds an Alarm

No one can escape the pressure to be perfect. Not anymore. Cultures and social groups once thought to be immune to America’s obsession with unrealistic standards of beauty are now reporting eating disorders in record numbers. While the news shatters the old stereotype that eating disorders only affect young white girls, the latest research also reveals that more studies are needed to solve a growing global crisis. A general lack of awareness may be preventing many from getting the help they desperately need, say activists like singer and actor Demi Lovato. Studies have proven that the sooner an eating disorder is treated, the greater the survivor’s chance of making a full recovery. That’s why it’s so critical, experts say, for healthcare professionals and the general public to understand how eating disorders affect all kinds of people.

A Dangerous Misconception

For many years, it was widely believed that eating disorders only affected young, white straight females and upper middle class women in Western cultures. The reality, is that eating disorders do not discriminate. They can affect people of all ages, racial/ethnic backgrounds, abilities socioeconomic status, gender identities and sexual orientations, around the globe. As Ovidio Bermudez, MD, a board member of NEDA, the National Eating Disorders Association, explains in Psychology Today, “The world in general, is becoming a more stressful place to grow up, in. Everyone has access to mass media and there are things being promoted that aren’t healthy, about body image, fitness…and we know that exposure matters.”

We Need to be Aware of Our Lack of Awareness

“There’s this mentality that this is a white chick illness,” nutritionist Michele Vivas, told “An African-American girl came in and her mom suggested to the school principal that they start a program to increase eating disorder awareness. The principal looked at her and said, ‘Why would we have that? Black folks don’t get eating disorders.’ ” Unfortunately, over the years, many healthcare providers have shared this misconception. Knowledgeable eating disorder professionals  fear that women of color are often unable to get the support and help they need to heal.

African Americans

A white majority may continue to dominate the number of cases in the U.S. for anorexia nervosa, but the data on other forms of eating disorders, especially among young women of color, is alarming. Challenging the long-held notion that bulimia nervosa primarily affects affluent white teenagers, a 10-year study by the National Heart, Lung and Blood Institute of schools in California, Ohio, and Washington, DC found that African-American girls were 50% more likely than white girls to be bulimic. The survey also demonstrated that eating disorders cross traditional barriers such as income and education levels.

  • 6% of the black girls surveyed were clinically bulimic, compared to 1.7% of the white girls.
  • Black girls scored an average of 17 percentage points higher than their white counterparts on the severity of their bulimia.
  • Girls from families in the lowest income bracket were significantly more likely to experience bulimia than were their wealthier peers.
  • Bulimia affected 1.5% of girls in households where at least one parent had a college degree.
  • For girls whose parents had a high school education or less, the rate of bulimia was more than double—3.3%.

Latin Americans

Ioana Boie, PhD, of Prosperity Eating Disorders and Wellness Center in Virginia, told Eating Disorder Hope, “Someone who grew up in a Latino community where the standards of appearance are related to having a curvier body type, and then goes to a school into a primarily Caucasian institution… finds that eating habits and eating norms are all different and these are all pressures that will put somebody at an increased risk.”

As a contributing writer for Seventeen magazine, actress Demi Lovato has spoken about her breakdown and the pressure she felt in school, despite her Latino heritage, to achieve perfection. A poll conducted by the magazine revealed that 74% of her readers admitted they felt the same way. “I started compulsively overeating at a very young age,” Lovato writes. “And then I almost stopped eating altogether at the age of 12, after being harassed by kids at school.”

Asian Americans

Asian American women often feel ignored in national discussions about mental health disorders. “It’s meaningful that a white woman can turn on a TV and find a broad range of characters, but Asian Americans are portrayed the same way over and over again,” Dr. Teresa Mok told Mochi magazine. “For someone struggling with self-esteem issues, this reinforces the feeling of invisibility.” Asian Americans also tend to underreport mental health issues, says Dr. Szu-Hui Lee, a clinical psychologist and director of training at Harvard Medical School. “There’s a big stigma with seeing a psychologist,” Dr. Lee adds. “Asian American women have one of the highest suicide rates. People really have to start scratching their heads and asking what’s wrong here.”

Native Americans

Numerous studies of various Native American populations in recent years have shown a high incidence of disordered eating symptoms among adolescents. One study, on the Chippewa tribe in Michigan, found that 74% were trying to lose weight. According to a survey of Native American teenagers:

  • 3% of the girls in grades 7-12 admitted they had dieted in the past year.
  • 5% of the boys reported dieting.
  • 28% of the girls reported purging behavior.
  • 21% of the boys reported purging behavior.


According to the National Association of Eating Disorders, in the U.S., 20 million women and 10 million men will suffer from a clinically significant eating disorder at some time in their life. These diagnoses include anorexia nervosa, bulimia nervosa, binge eating disorder, or OSFED, other specified feeding or eating disorders. But males are closing the gap. A recent study in Los Angeles showed that the growing numbers of high school males are almost equal to females for most eating disorders.

  • Subclinical eating disordered behaviors (including binge eating, purging, laxative abuse and fasting for weight loss) are nearly as common among males as they are among females.
  • Studies suggest that risk of mortality for males with eating disorders is higher than it is for females.
  • Men with eating disorders often tend to suffer from comorbid conditions such as depression, excessive exercise, substance disorders, and anxiety.

The LGBTQ Community

Statistics on LGBTQ Populations and Eating Disorders are somewhat limited and conflicting. But researchers found:

  • While research indicates that lesbian women may experience less body dissatisfaction overall, research shows that beginning as early as 12, gay, lesbian, and bisexual teens may be at higher risk of binge-eating and purging than heterosexual peers.
  • In one study, gay and bisexual boys reported being significantly more likely to have fasted, vomited or taken laxatives or diet pills to control their weight in the last 30 days.
  • Gay males were 7 times more likely to report binging and 12 times more likely to report purging than heterosexual males.
  • Females identified as lesbian, bisexual, or ‘mostly heterosexual’ were about twice as likely to report binge-eating at least once per month in the last year.
  • Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for both males and females who identified as gay, lesbian, bisexual or “mostly heterosexual” in comparison to their heterosexual peers.
  • Compared to other populations, gay men are disproportionately found to have body image disturbances and eating disorder behavior.
  • Gay men are thought to only represent 5% of the total male population, but among men who have eating disorders, 42% identify as gay.
  • Compared with heterosexual men, gay and bisexual men had a significantly higher prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder.
  • Respondents aged 18–29 were significantly more likely than those aged 30–59 to have subclinical bulimia.

The Key to Prevention

The answer to the growing eating disorder problem among ethnic groups, one young Korean American college student insists, is talking about it. “Talk to someone,” she urged readers of Mochi magazine. “It sounds easier than it is. Eating disorders make you secretive and distrustful of everyone. But choose one person that you can confide in, and at least hear someone else other than your brain that’s tearing you down enough to punish your body.”

Recovery is Possible, Demi Lovato Says

“If you or someone you know if suffering from an eating disorder, it’s important to speak up and seek professional help,” says Ms. Lovato. “You can get help, and you can feel better. My eating disorder will continue to affect me for the rest of my life, but I’m proud to say that I got the help I needed, and am now the happiest and healthiest I have ever been!”

Need Help?

At Center for Discovery, we’ve been guiding families to long-lasting recovery for nearly 20 years. Our personalized behavior modification programs are tailored to fit your family’s needs. Call us now at 800.760.3934. Center for Discovery’s integrated multi-faceted levels of care range from residential treatment, intensive outpatient treatment, to partial hospitalization for adults, adolescents, and teens that are struggling with eating disorders, depression, anxiety disorders, bipolar disorder, and most major mental health disorders.

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Slate: Eating Disorders Do Not Discriminate, by Michelle Konstantinovsky. Retrieved November 21, 2016.

Mirror Mirror Eating Disorder: Who Gets Eating Disorders – Diversity And Eating Disorders, by Dr. Lauren Muhlheim, Tabitha Farrar, and Dagan VanDemark. Retrieved November 21, 2016.

Seventeen: My Battle with Eating Disorders, by Demi Lovato. Retrieved November 21, 2016.

Adios Barbie: Why Eating Disorders Are More Than a “Western” Problem, by Kira Rakova. Retrieved November 21, 2016.

Mochi Magazine: Diagnosing the Asian American Eating Disorder, by Mandy Yeh. Retrieved November 21, 2016.

Psychology Today: What’s Behind the Dramatic Rise in Childhood Eating Disorders Hospitalizations? by Nancy Matsumoto. Retrieved November 21, 2016.

NEDA: Research on Males and Eating Disorders. Retrieved November 21, 2016.