Men and Minorities face an unique set of challenges. It is only recently that they have been recognized to also suffer eating disorders. Now that there is recognition, there exists the goal of treatment and eventually eradication. Issues to be resolved are family and cultural stigma, acculturation, research and reporting bias, and barriers to treatment.
Challenge #1 Acknowlege Eating Disorders Exist in outside of "traditional populations"
In a study of 1,061 African American women and 985 white women, it was found that fifteen white (1.5%) and no black women met lifetime criteria for anorexia nervosa; 2.3% of white women and 0.4% of black women met criteria for bulimia nervosa; binge eating disorder also was more common among white women 2.7% than black women 1.4%. Fewer white women (28.1%) than black women (5.3%) ever had received treatment for an eating disorder(Striegel-Moore et al, American Journal of Psychiatry. 160(7):1326-31, 2003 Jul).
Challenge #2 Acknowlege the barriers that exist in obtaining treatment. Sadly, there are barriers that continue to exist regardless of ethnicity.
Treatment seeking behavior was examined for Mexican American and European Americans with eating disorders. One hundred forty-five women with eating disorders (76 Mexican American, 69 European American) were diagnosed using the Structured Clinical Interview for DSM-IV-TR (SCID-IV) and Eating Disorder Examination (EDE). Only 28% of the sample reported having sought treatment for their eating problems and only 17% had received treatment. Although both groups were equally likely to believe they have significant eating problems and to want help. However, Mexican Americans were less likely to have sought treatment and, having sought help, were less likely to have been diagnosed or treated. European Americans were more likely to have utilized psychotherapists, psychiatrists, and psychotropic medications, whereas Mexican Americans largely had sought help from general practitioners for weight concern (Cachelin FM. Striegel-Moore RH;International Journal of Eating Disorders. 39(2):154-61, 2006).
Barriers to treatment for minorities include shame and fear of stigma, poor provider recognition of eating disorders in minorities, cultural perceptions of psychiatric illness, minimizing the problem, discomfort with seeing a mental health provider, financial difficulties and lack of health insurance, and lack of ethnically representative professional staff (Cachelin FM. Striegel-Moore RH; International Journal of Eating Disorders 30(3):269-78, 2001).
Our goal as advocates:
Our goal is to reduce the effect of these challenges. Increasing provider knowledge, encouraging research with minority populations and above all eliminating shame and stigma so minorities and men will be more likely to present to mental providers is key to achieve our aims. Lastly, promotion of education within communities to help people reduce their own shame about the illnesses and mental health will help facilitate early identification of these disorders.
Links
Minority Women with Eating Disorders
Minorities, the untold story
Men and Eating Disorders
NPR--Men with Eating Disorders
A True Picture of Eating Disorders in African American Women: A review of literature
NPR--African Americans with Eating Disorders
Impact of Racial Stereotypes on Eating Disorder Recognition
Culture and Eating Disorders: A Historical and Cross-Cultural Review
Eating Disorders in Males: A Report on 135 patients
NPR--Behind Closed Doors: Latino Binge Eating
Women of Color and Eating Disorders
Type I Diabetes and Eating Disorders