Thursday, December 17, 2009

Bulimia Study: "Treat Blacks" and "Treat Bulimia as an Addiction"

For far too long eating disorders in the Black community have been ignored.  The joke has long been that anorexia  or bulimia are something that happens when the main provider loses their job.  Eating disorders have long been understood as something that occurs with middle/upper class White girls and women.  Race is no protector from the harmful images aimed at women or its effects.

Today, I wanted to share my conversation with Michelle Goeree, a USC economics professor, who, along with researchers from the University of Maryland and the Autonomous University of Barcelona, published "Caught in the Bulimic Trap?"

Their study found that African American girls are 50% more likely to be bulimic than white girls and that girls from low-income families are more likely to be bulimic than girls from middle- and high-income families.
Goeree says those results surprised her.

"Prior to this research, we also held the popular conception that eating disorders (and bulimia) were more common among girls from white, mid-to-high income families," Goeree says.

"We were less surprised after we realized that insurance may not cover the expensive doctor visit where a girl with an eating disorder gets diagnosed," she adds.

"If two girls both suffer from bulimia nervosa, but one is from a low-income family and the other from a high-income family, which girl is most likely to be diagnosed if it requires a visit to the expensive psychiatrist?" Goeree asks.

"Girls who are African American and/or come from low-income families are much less likely to be diagnosed with an eating disorder conditional on having an eating disorder," Goeree says.

In other words, we all have the idea that bulimia impacts middle-class white girls because they are more likely to receive the diagnosis when, according to the study, African American girls are more likely to exhibit and persist in bulimic behavior.

As I mentioned yesterday, as many as 11 million Americans have an eating disorder. Bulimia nervosa, the life-threatening disorder that Goeree's study focused on, is characterized by a cycle of eating unusually large amounts of food (bingeing) followed by compensatory behavior to purge the food, such as vomiting, excessive use of laxatives or diuretics, fasting or excessive exercise.

Goeree's study also found something that was equally compelling -- "bulimic behavior is consistent with an addiction."

Once again we can see the intersection between race, class, and gender combining to effect to the lives of WOC.   How many women die because they do not have the capitol to seek help?  How many of them go undiagnosed because bulimia is understood to be a disease effecting only White women? 

The following is from Women’s Health .Gov:

Who becomes bulimic?

Many people think that eating disorders affect only young, upper-class White females. It is true that most bulimics are women (around 85-90 percent). But bulimia affects people from all walks of life, including males, women of color, and even older women.  It is not known for sure whether African American, Latina, Asian/Pacific Islander, and American Indian and Alaska Native people develop eating disorders because American culture values thin people. People with different cultural backgrounds may develop eating disorders because it’s hard to adapt to a new culture (a theory called “culture clash”). The stress of trying to live in two different cultures may cause some minorities to develop their eating disorders.

 

What causes bulimia?

Bulimia is more than just a problem with food. A binge can be triggered by dieting, stress, or uncomfortable emotions, such as anger or sadness. Purging and other actions to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. There is no single known cause of bulimia, but there are some factors that may play a part.

  • Culture. Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies.
  • Families. If you have a mother or sister with bulimia, you are more likely to also have bulimia. Parents who think looks are important, diet themselves, or criticize their children's bodies are more likely to have a child with bulimia. 
  • Life changes or stressful events. Traumatic events (like rape), as well as stressful things (like starting a new job), can lead to bulimia.
  • Personality traits. A person with bulimia may not like herself, hate the way she looks, or feel hopeless. She may be very moody, have problems expressing anger, or have a hard time controlling impulsive behaviours.
  • Biology. Genes, hormones, and chemicals in the brain may be factors in developing bulimia.

I will be first to admit that this is not a subject with which I am well acquainted.  Like many other women, I have issues in relation to my body size and shape but they have not resulted in bulimia.  I am very concerned with the ways in which race and class intersect to jeopardize the lives of women of color.  I think this is particularly important to focus on while the U.S. is in a heated debate regarding socializing their healthcare system.   Clearly this is one condition that such a system could help to alleviate.  If we truly believed that women matter it would never be acceptable to allow this sort callousness in regard to their health care needs.