Bulimia is not just a “rich white girl’s disease”

25 03 2009

There is a misconception that bulimia, and other eating disorders, are generally only problems that rich, white women or teenagers have.  However, a new study debunks that myth and reveals that black women and low income women are more likely than white women to be bulimic.

Girls and young women from schools in California, Ohio and Washington, D.C. between the ages of 9 and 20 were surveyed about their eating habits and their body image.  There were an equal number of black and white participants.

Black girls are 50 percent more likely than white girls to develop bulimia, and girls from low income families are 153 percent more likely to develop bulimia than girls from wealthier families.  Why is this so?

Lead researcher Michelle Goeree said the misconception that eating disorders are a “white woman’s” problem comes from previous studies that focused on hospital admission data, which wouldn’t include girls who don’t seek professional help for their illness. In most states, treatment for eating disorders isn’t covered by insurance.

“Who goes to the hospital? Those who have insurance. Who tends to have insurance? Wealthier, better-educated people,” said Goeree, an economist at the University of Southern California.

Goeree said minority parents also may be less likely to recognize bulimic behavior, such as purging in their children.

Goeree is right on point.  Eating disorders aren’t specific to wealthy white women.  It may seem like they disproportionally affect wealthy white women, but it’s more about who has access.  Who has access to education about eating disorders and treatment services?  Who can afford to seek professional help/treatment?  Mostly, it’s people pertaining to higher income brackets in society.

This study also has very important implications on education and policy-making.  Instead of designing education about body image and eating disorders specifically for wealthy white women, what was thought of as the most vulnerable group, it is necessary to also reach other populations, other populations who need it more and can benefit from it most.

In terms of policy-making, it’s important to revise policies or construct them with consideration to who the vulnerable groups are – lower income minority women.  The Chicago Sun Times notes:

Based on their findings about the persistence of bulimic behavior and who is afflicted, the researchers argue that bulimia, which is currently classified as a disorder, would perhaps be more accurately described — and treated — as an addiction. As with drug and alcohol addictions, this would mean more federal, state and local treatment programs and fewer out-of-pocket insurance costs.

Replacing out-of-pocket insurance expenses with more federal, state and local treatment programs will enable treatment for eating disorders to be more accessible for lower income populations.  It would address the health care disparities and break down some barriers to access to health care.

What I’m wondering about is how eating disorders affect men as well.  Women aren’t the only ones affected by eating disorders, even if they make up a larger portion of the affected population.  Furthermore, in diagnosing and treating eating disorders there is so much focus on eating disorders as a physical disease but there needs to be more focus on the emotional/psychological side of eating disorders.


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