Disordered eating can influence a person's health and well-being throughout their lifetime. But the majority of research on this subject has focused on the experiences of white women, contributing to the myth that eating disorders don't affect Black women, according to researcher Jordan E. Parker (University of California, Los Angeles). A new study by Parker and colleagues in Clinical Psychological Science debunks that myth by demonstrating that childhood symptoms of disordered eating are predictive of symptoms in adulthood for both Black and white women.
"These findings affirm more recent assertions that Black women are not immune from body-image and eating disturbances, highlighting the adulthood risk associated with disordered-eating behaviors for both white and Black girls," Parker and colleagues wrote in the article.
Parker and colleagues explored the stability of disordered-eating symptoms from adolescence into adulthood by analyzing existing data from the 1987 National Heart, Lung, and Blood Institute's Growth and Health Study. This allowed the researchers to compare the self-reported eating behavior and cognition of 883 Black and white women who completed the Eating Disorder Inventory (EDI), including measures of body dissatisfaction, drive for thinness, and symptoms of bulimia, from ages 12 to 19 and again at age 40.
Overall, the researchers found that 30% of Black participants and 50% of white participants scored highly enough on the EDI to be at a typical or elevated risk for bulimia nervosa, a condition that involves overeating and purging, or self-induced vomiting. Meanwhile, 2% of Black participants and 8% of white participants had a typical or elevated risk for anorexia nervosa, a condition that involves restricting food intake.
Regardless of race, however, participants who scored higher on measures of body dissatisfaction and drive for thinness from ages 12 to 19 also had higher scores at age 40. This means that their symptoms remained largely stable over a 28-year period, Parker explained in an interview. Participants' childhood symptoms of bulimia were also found to predict bulimia in adulthood, although the exact timeline varied somewhat by race: Black women's symptoms were predicted only by symptoms at ages 18 and 19, whereas white women's symptoms were predicted by symptoms throughout childhood.
Numerous psychological and cultural factors could cause symptoms of bulimia to present later in Black women, Parker and colleagues wrote.
"In the domain of cultural and psychological influence, it may be that as Black girls enter adulthood, they experience greater pressures toward acculturation, leading to idealization of thinner figures and subsequent engagement in bulimic behaviors to achieve said silhouette," the researchers wrote. The higher number of multigenerational households in Black communities could also prevent younger girls from engaging in bulimic behaviors like purging, which are often performed in secret, the researchers noted.
The central purpose of this research, Parker said in the interview, was to highlight the prevalence of disordered-eating behaviors among Black women, who are often overlooked in the literature on disordered eating.
"This will hopefully point research and treatment efforts toward acknowledging disordered eating behaviors when they present in Black women instead of assuming that these disorders aren't prevalent in this demographic," Parker said. "Black women and girls deserve research attention, clinical attention, and funding in these areas as well."
In future work, Parker would like to further investigate how effectively the EDI measures disordered eating, and binge-eating disorder in particular, in Black participants. Although previous research suggests that the EDI is a reliable measure of bulimia and anorexia in this population, it may still overlook concerns related to body dissatisfaction, such as skin color, that may uniquely affect Black girls' and women's eating behaviors, the researchers noted.
Reference
Parker, J. E., Levinson, J. A., Hunger, J. M., Enders, C. K., Laraia, B. A., Epel, E. S., & Tomiyama, A. J. (2023). Longitudinal stability of disordered-eating symptoms from age 12 to 40 in Black and white women. Clinical Psychological Science. https://doi.org/10.1177/21677026221144253
