A true picture of eating disorders among African American women: a review of literature.

Abstract: A review of published studies reveals a serious deficit in scope of eating disorders among African American women. While the "Prevalence of Eating Disorders Among African American Women" (Mulholland & Mintz, 2001), and "A Comparison of Black and White Women With Binge Eating Disorder" (Pike, Dohm, Stiegel-Moore, Wilfley, & Fairburn, 2001) offer substantial findings in an area of under representation, the findings of these studies leave many vacancies in the true picture of eating disorders among African American women. Sufficient examination of the relationship of familial roles, cultural influences, and unique Stressors to African American women are not prevalent in the available studies and are not evaluated as substantial influences on maladaptive eating regulation responses. Key Words: African American Women, Eating Disorders The exclusion of women from prominent research studies, such as research on heart disease, cancer, and aging, has been well documented. This exclusion has resulted in the development of research and clinical studies, which specifically concentrate on women. When examining studies conducted on eating disorders, there is a major focus on infants, children, and adult women, Caucasian women. There is a deficit of research studies, which evaluate the prevalence of eating disorders among African-American women. Upon evaluation of the literature, there is reason to question if a true picture of eating disorders among African-American women has been identified. Principles and Practice of Psychiatric Nursing (Stuart & Laraia, 2001) defines eating disorders as the use of food "...to satisfy unmet emotional needs, to moderate stress, and to provide rewards or punishments". Further, "the inability to regulate eating habits and the frequent tendency to overuse or under use food interferes with biological, psychological, and sociocultural integrity" (Stuart & Laraia, 2001, p. 526-527). Anorexia nervosa, bulimia nervosa, and binge eating disorder are illnesses associated with maladaptive eating regulation responses and are most commonly seen in women. Decisive factors for anorexia nervosa established by the Diagnostic and Statistical Manual of Mental Diaorders (4th ed.; DSM-IV) include extreme weight loss, fear of fat, and loss of menstruation. Bulimia nervosa is defined by self-esteem that is unduly influenced by weight and shape and both binge eating and inappropriate compensatory behaviors (e.g., self-induced vomiting) at specified frequencies. Binge eating disorder not otherwise specified (EDNOS) is appropriate for "disorders of eating that do not meet the criteria for any specific Eating Disorder" (American Psychiatric Association, 1994, p. 550). DSM-IV (1994) lists six examples of EDNOS, including meeting all the criteria for anorexia except loss of menstruation, meeting all the criteria for bulimia except frequency, use of inappropriate compensatory behaviors after eating small amounts of food, and binge eating in the absence of inappropriate compensatory behaviors (binge-eating disorder). Eating disorders in the United States is experienced about the same among Hispanics and whites, is more common among Native Americans, and is less common among blacks and Asians (Stuart & Laraia, 2001). Because many women do not meet diagnostic criteria, yet are symptomatic by occasionally engage in behaviors characteristic of eating disorders, including self-induced vomiting, use of laxatives, and binge eating, it is important to evaluate women who are symptomatic of eating disorders. In "Prevalence of Eating Disorders Among African American Women" (Mulholland & Mintz, 2001), a significant study was conducted at a large public university in the Midwestern United States that identified two percent (2%) of African American women participants as eating disordered. In contrast, "A Comparison of Black and White Women With Binge Eating Disorder" (Pike, Dohm, Stiegel-Moore, Wilfley, & Fairburn, 2001) evaluates differences in Caucasian and African American women with an eating disorder; the research showed that the women differ in all aspects of binge eating disorder. …