There is often a misconception that eating disorders are primarily a “young, white woman of privilege” problem and that other races, ethnicities, and cultures do not struggle with the disorder. This can often make it difficult for individuals to enter eating disorder treatment if they do not fit this image. According to the National Eating Disorders Association (NEDA) website, the prevalence of eating disorders in other cultures is unknown as there is limited research into the area of eating disorders and other races/ethnicities/cultures. However, reports of eating disorders in other cultures are on the rise.
In fact, NEDA reports that:
- African American girls aged 11-14 consistently scored higher than white girls of the same age on all eating disorder inventory scales measuring features commonly associated with eating disorders except for body dissatisfaction and drive for thinness.
- Black girls may be especially vulnerable to developing eating disorders with binge eating features.
- Asian and Asian-American women are becoming increasingly susceptible to eating and body image problems.
- The leanest 25% of 6th and 7th-grade girls, Hispanics, and Asians reported significantly more body dissatisfaction than did white girls.
- 3% of Native American teen girls and 30.5% Native American teen boys in grades 7-12 had dieted in the past year, and of those who were studied, 28% of girls and 21% of boys reported purging behavior.
So, how do these findings impact individuals of different races and ethnicities who struggle with eating disorders? To help answer this question, I interviewed, Chani Coady, a bi-racial social worker who struggles with Binge-Eating Disorder.
Please tell us a little bit about yourself and your journey.
I have always had a tumultuous relationship with food. Growing up poor, I didn’t always know when or what my next meal would be, so I ate as much as I could as often as I could in the off chance that I wouldn’t get to eat the next day. I was a relatively active kid, so my weight didn’t really start showing until I was about nine. I was also really tall, so I think everyone thought I’d grow into my weight.
When I was 22 I entered graduate school and was alone on my own for the first time. I was nervous about being in a new city with no family around. So nervous, in fact, that I rarely left my apartment and would comfort myself with food. After a while, I realized that I had gained a lot of weight, so I began to use a number of behaviors including calorie counting, restricting, over-exercising, and purging. Then, just as soon as I started, I stopped, probably because deep down I knew how terrible it was for me. I was ok for a few years, but did keep gaining weight steadily.
I finally realized that I had a serious problem with food and my weight after trying to get pregnant for a while to no avail. I was crushed, but I knew I needed to do something about it and that I needed help. Thankfully, I live close to a wonderful organization called The Emily Program, which had an intensive outpatient program for Binge-Eating Disorder. I enrolled and worked the program to completion. I have been binge-free since June 2014.
While my mind was recovered, my body was not. I thought long and hard about my decision, but I underwent gastric bypass surgery in May 2015. I knew that I couldn’t lose weight without a tool to help me considering all of the times I had tried before. It’s not a magic fix – I only eat so much, focus on eating enough protein, and still need to exercise in order to lose weight. I am happy with my decision, but I couldn’t have done it unless I did the intensive outpatient program first.
What misconceptions did you carry about eating disorders that impacted your own awareness of struggling with the disorder?
I always thought eating disorders plagued young, white, middle to upper-class women. I was totally wrong. Eating disorders do not know race, gender, class, or age. Therefore, since I didn’t quite fit the mold of your “typical” person with an eating disorder, I thought I didn’t have one. Also, the media really focuses on Anorexia Nervosa and Bulimia Nervosa as the only eating disorders out there, which is simply not true. Even as a mental health professional, I had only heard of Binge-Eating Disorder a few times.
Eating disorders are typically seen as affecting only “young, white women of privilege”. How did this bias affect your journey to seek treatment?
I was scared to go into treatment at first. I thought that I might be turned away because I didn’t quite “fit in”, so to speak. I think that a big part of recovery is also being able to learn about others’ experiences, so I was really nervous that I wouldn’t have been able to relate to any of my group members. However, I took the plunge because I knew I needed help.
How did this bias affect treatment once you began? Were you able to participate in the group process and develop an identity or bond with others in the group setting?
I was with a wonderful group of women who accepted me as I am, and I am forever thankful for that. Even though I was the only person of color, I found that my experiences were less about race and culture and more about discrimination based on size or weight, and I think that definitely helped solidify that bond. Even though everyone had different life experiences, the fact that we were also all in a specialized program for binge eating really helped.
According to the NEDA website, “it is frequently asserted that African-American culture embraces larger body types than does the dominant culture.” What has been your experience of this and do you think that this has had an impact on your own experience with an eating disorder?
I would definitely agree with this statement. Growing up in predominantly white areas, especially as a teenager, I was often ridiculed by men because of my weight. However, going to graduate school and moving to an urban area, I suddenly found myself being pursued by men who LIKED my body type – after being told for years that I was unattractive. It made me really uncomfortable, probably because I couldn’t wrap my head around the fact that someone might find me attractive as I am – because society and the media told me that I was unattractive and unworthy. In a sense, I think that it contributed to my eating disorder – I would eat to hide uncomfortable feelings, and those feelings were definitely there. After treatment, I slowly began to accept the fact that I could be attractive based on things besides my weight and body type…still totally a work in progress though!
There has been a large shift in the public to focus on the “obesity epidemic” with a goal of promoting increased physical activity and improved eating habits for children and adolescents. How has this impacted your personal journey with binge eating disorder?
I often think that these programs do more harm than good. Most obese people do, in fact, realize that they are obese. I am a firm believer that unless someone is ready to change, they will not – despite all the education available to them. I cannot count the number of times that doctors told me, “just eat less and exercise more”. If it were that simple, no one would be overweight! I don’t think that programs aimed at combating obesity focus on the reasons that people develop an eating disorder, they are just addressing the physical aspect. It’s important to heal your mind at the same time you’re healing your body.
Based upon your experience, what feedback would you provide to professionals working with clients who struggle with eating disorders in terms of being more culturally aware and sensitive?
I think first and foremost, don’t be afraid to ask your clients about their culture. Ask them questions so that you can understand their background and cultural norms and expectations. Once you get a better understanding of their beliefs, delve a little bit more into the cultural norms and expectations as a whole so you can see if there is any disconnect or similarities between their beliefs and normative cultural beliefs. Don’t assume. Encourage clients to challenge those cultural norms as well – this may mean challenging your own cultural norms at the same time.
For more on Chani and her story please check-out NEDA’s Marginalized Voices Project.