Study Reveals Stunning Prevalence of Bulimia Among African-American Girls
By Hugh C. McBride
Experts have long been aware that eating disorders can affect boys, girls, men, and women of virtually all age groups, racial backgrounds, and socioeconomic levels. But that information hasn’t made much of an impact on the public consciousness, where the words “eating disorder” are still most likely to conjure images of an emaciated white teenage girl from a relatively well-to-do family.
A landmark study conducted by economists from three universities on two continents may finally begin to correct that misperception.
According to a March 20 article on the website of the University of Southern California, a study that was led by USC economist Michelle Goeree has revealed that African-American teen girls are 50 percent more likely to suffer from bulimia than white girls are.
USC News writer Suzanne Wu noted that the study yielded a second surprise, discovering that the bulimia rate among girls whose families were in the lowest income category was significantly higher than the rate among girls from the highest income bracket. The likelihood of the poorest girls exhibiting symptoms of bulimia was 153 percent greater than the prevalence of the disorder among the richest girls, the researchers reported.
“The difference between public perception and our results is striking,” Goeree said in the USC News article.
A Decade’s Worth of Research
Goeree and her study colleagues (John Ham of the University of Maryland and Daniela Iorio of Universitat de Autonoma in Barcelona, Spain) analyzed data that had been collected during a decade-long survey of schoolgirls in Ohio, California, and Washington, D.C.
The survey, which tracked more than 2,300 girls from age 9 or 10 to age 19 or 20, involved annual inquiries on topics that included eating habits, body image, and depression. Results of the Goeree team’s analysis included the following:
- African-American girls were 50 percent more likely than white girls to exhibit bulimic behavior, including both binging and purging.
- About 2.6 percent of the black girls who were surveyed were determined to be clinically bulimic, as were 1.7 percent of white girls.
- Overall, approximately 2.2 percent of the girls surveyed were found to be clinically bulimic, a number that the researchers noted was close to the national average.
In addition to being afflicted with bulimia at a higher rate than their white peers, the African-American girls in the survey were found to suffer from a more severe version of the disorder. USC News reported that the African-American girls scored an average of 17 points higher than did their white peers on a medical index that charts the severity of the eating disorder.
The racial disparity was not the only surprising finding by Goeree’s team. The three economists also determined that poverty and lower levels of education were associated with higher rates of bulimia, which goes against the common belief that bulimia and other eating disorders are “diseases of privilege.” The team’s economic and education-related findings included the following:
- Girls from families who placed in the lowest income bracket were significantly more likely to experience bulimia than were their wealthier peers.
- Bulimia affected 1.5 percent of girls in households where at least one parent had a college degree.
- For girls whose parents had a high school education or less, the rate of bulimia (3.3 percent) was more than double the rate of the college-educated households.
“As it turns out, we learned something surprising from our data about who bulimia actually affects, not just who is diagnosed,” Goeree told USC News, noting that previous misconceptions about the prevalence of bulimia among minority groups and members of lower socioeconomic classes may have been based on the faulty premise that those who are treated for eating disorders are the only ones who are suffering from the conditions.
“One explanation is straightforward,” she said. “Girls with an eating disorder who are African-American or come from low-income families are much less likely to be diagnosed. Who goes to the hospital? Those who have insurance. Who tends to have insurance? Wealthier, better-educated people.”
One of the two most common eating disorders (along with anorexia nervosa), bulimia nervosa is marked by a “bingeing and purging” behavior in which sufferers eat relatively large amounts of food, then rid their bodies of what they have eaten through forced vomiting, the ingestion of laxatives, or obsessive exercise.
Symptoms of bulimia and other eating disorders include dramatic weight loss, a preoccupation with food, an excessive concern about one’s weight and body shape, and a propensity for making disparaging remarks about one’s own body or the shape and sizes of others.
Bulimia treatment often involves a combination of medical intervention, nutritional education, and cognitive-behavioral therapy. Some individuals are able to overcome bulimia via outpatient therapy, while those with more severe or long-lasting eating disorders require hospitalization or other residential care.