From the Guidelines
Eating disorders affect people across all demographics, but certain populations, including men, racial and ethnic minorities, LGBTQ+ individuals, older adults, people with disabilities, and those from lower socioeconomic backgrounds, remain underrepresented in research, diagnosis, and treatment. These populations often face unique challenges and barriers to accessing care, which can lead to delayed diagnosis and treatment, resulting in poorer outcomes and increased morbidity and mortality 1.
Key Characteristics of Eating Disorders in Underrepresented Populations
- Men with eating disorders often go undiagnosed due to the misconception that these are "women's issues"
- Cultural factors can mask symptoms in racial and ethnic minorities, making diagnosis and treatment more challenging
- LGBTQ+ individuals face higher rates of eating disorders due to minority stress and body image concerns specific to their communities
- Older adults' symptoms may be attributed to aging or other medical conditions rather than recognized as eating disorders
- People with disabilities may develop disordered eating as a response to limited control over their bodies or medical care
- Those from lower socioeconomic backgrounds often lack access to specialized treatment
Importance of Culturally Sensitive Approaches
Healthcare providers should maintain awareness of these disparities, screen all patients regardless of demographic characteristics, adapt culturally sensitive approaches, and advocate for inclusive research and treatment options that address the unique needs of these underrepresented populations 1.
Recent Guidelines and Recommendations
The American Psychiatric Association recommends a comprehensive initial evaluation, including weighing the patient, quantifying eating and weight control behaviors, identifying co-occurring health conditions, and conducting a comprehensive review of systems 1.
Prioritizing Morbidity, Mortality, and Quality of Life
Prioritizing the single most recent and highest quality study, the 2023 American Psychiatric Association practice guideline for the treatment of patients with eating disorders, healthcare providers should prioritize early recognition, diagnosis, and treatment of eating disorders in underrepresented populations to improve outcomes and reduce morbidity and mortality 1.
From the Research
Characteristics of Eating Disorders in Underrepresented Populations
- Eating disorders affect individuals from diverse ethnic and minority groups, but research on these populations is limited 2
- Studies have shown that financial barriers, geographic location, eating disorder identification, sociocultural factors, and treatment quality can disproportionately affect underrepresented groups 3
- Minority ethnic populations, particularly Asian populations, have been found to have limited access to eating disorder treatment and experiences 2
- There is a need for further research addressing inequities in eating disorder prevalence, service access, and treatment experiences among minority ethnic and Indigenous groups 2
Prevalence and Treatment Experience
- The majority of studies on eating disorders in minority ethnic populations have been conducted in the UK, with a notable lack of studies in Australia, Canada, and Aotearoa New Zealand 2
- Most studies have utilized cross-sectional survey designs and focused on non-clinical samples of adolescents and young adults 2
- Understanding of prevalence and treatment experience amongst minority ethnic groups is limited, highlighting the need for improved ethnicity data collection and culturally sensitive approaches to assessment, diagnosis, and treatment 2
Barriers to Treatment Access
- Financial barriers, such as lack of insurance coverage, are the most frequently reported barrier to treatment access for eating disorders 3
- Geographic location, eating disorder identification, sociocultural factors, and treatment quality can also act as barriers to treatment access, particularly for underrepresented groups 3
- Higher frequencies of reported barriers to treatment access are associated with more severe eating disorder symptoms and poorer illness trajectories 3