Most African Americans are surely aware of the worsening obesity rates in this country, especially among poorer and underserved communities. According to the Centers for Disease Control and Prevention, African Americans are the most overweight racial group, with 47 percent classified as obese—defined as a body mass index of 30 or higher.
But less often discussed among African Americans are eating disorders, such as anorexia and bulimia. Those afflicted with anorexia have a body image that is so distorted that they severely restrict calories—either through extreme dieting or purging or even by abusing laxatives and enemas—which leads to severe weight loss. Bulimia sufferers, on the other hand, may have a normal body weight but live in a cycle of overeating and purging or use other extreme measures, such as dieting and overexercising, often for hours at a time.
Some in the black community may typically associate these eating disorders with white teenage girls or 20-something women from middle- to upper-class backgrounds, but African Americans should start paying more attention to this issue. According to a 2007 study by the International Journal of Eating Disorders, only 2 percent of black Americans reported binge eating, yet experts consistently point out that the number of African Americans suffering from eating disorders is likely higher, given our collective reluctance to seek treatment for eating disorders.
To date, there does not exist a multitude of eating-disorder studies that include women of color. (Eating disorders mostly affect women, although more men are seeking treatment.) This makes it very difficult to get exact numbers on the prevalence of eating disorders among African Americans. To make matters worse, a 2006 study showed that physicians demonstrated a bias against diagnosing women of color with an eating disorder, further perpetuating the stigma that we don’t develop these disorders.
Another issue that is becoming more common in the African-American community, as well as in Latino and Native American populations, is binge eating disorder. BED is similar to bulimia but without the compensatory mechanism of purging, extreme dieting or overexercising.
The best example of BED I can think of is the dinner scenes from The Nutty Professor, featuring Eddie Murphy as several members of the Klump family. In several of those scenes, there is praise for eating dense, calorically rich foods, often past the point of fullness. In real life, however, those who binge-eat often do it alone or late at night to avoid arousing others’ suspicion. They may have issues with anxiety and use binge eating as a temporary fix, which only serves to promote shame and ultimately depression, which worsens the anxiety, which leads to more binge eating. And thus the cycle starts all over again.
To be clear, BED is a specific illness that is often present with anxiety and clinical depression. It is not found in all overweight people. It is, however, a mental illness that can have severe medical implications and cause medical complications. It is also a disease that can be treated by professionals who are trained to treat eating disorders, who will likely use psychotherapy or medication or both to help someone get better.
As with all mental and other medical disorders, it is important to find a clinician whom you feel most comfortable with in order to treat these illnesses successfully.
Although there are high rates of recidivism in eating disorders, what is most important to remember is that these are disorders, not a function of not having enough willpower to stop engaging in binge-eating behaviors. Having a great support network is crucial, not just for those who are afflicted but also for their loved ones.
If you or anyone you know has an issue with an eating disorder, the National Eating Disorders Association website is a good place to start.
Dr. Imani J. Walker is a physician trained in general adult psychiatry who resides in Los Angeles, where she also treats patients with mental illness.
Dr. Imani J. Walker is a physician trained in general adult and forensic psychiatry. She resides in Los Angeles.