Monday, September 26, 2022

Why Are Females More Likely To Have An Eating Disorder

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Eating Disorders: Why Are Girls More Affected?

One major barrier for women of colour is the prevailing stereotype that eating disorders are a thin white womans affliction. A 2019 YouGov poll found that 39% of people in the UK thought eating disorders were more common in white people. However, several studies prove that this is a misconception and that these illnesses are just as common, if not more so, among minority groups.

Even more worryingly, a study published in the International Journal of Eating Disorders found that among a group of 1,700 young people with eating disorder symptoms, those who didnt meet the SWAG stereotype were significantly less likely to have received a diagnosis or treatment in the past 12 months.

Looking back, Millie feels this may have delayed her diagnosis. I didnt fit into the anorexic ideal and it was clear from the demographic in the mental health unit that brown peoples mental health isnt taken seriously.

Reduced recognition of eating disorders among Black, Asian and minority ethnic women by healthcare professionals means their illnesses are more likely to fly under the radar, explains Dr Natalie Kanakam, a clinical psychologist at the Maudsley Hospital.

Stanford Researchers Expand Comparison Of Males And Females With Anorexia

Research on anorexia nervosa often excludes boys and men, who make up about 10 percent of those affected by the serious eating disorder.

This omission has made it hard for doctors to know if the disease has different consequences in boys and girls, which is a problem because the proportion of male patients diagnosed is rising. Since anorexia radically alters body composition, and the sex hormones estrogen and testosterone also influence bone density, fat mass and muscle mass, it makes sense to question whether the disease changes males and females bodies differently. Scientists also want to know how having an eating disorder may affect men throughout life more on that below.

Recently, a team of researchers from Stanford and other universities, led by Jason Nagata, MD, a former pediatrics resident at Stanford who is now at the University of California-San Francisco, have published a series of papers to help fill this knowledge gap. In September, the team published findings that among teens who had had anorexia for a short time, bone density didnt differ between male and female patients. Instead, the strongest determinant of low bone density a marker for fracture risk was how malnourished patients were.

Overall, the data imply that malnutrition plays a bigger role than gender, and that disease severity should guide whether doctors decide to order tests such as bone scans for their anorexic patients.

Prevalence Of Eating Disorders Among Ethnic Minorities

In the past, eating disorders have been characterized as culture-bound syndromes, specific to Caucasian subjects in Western, industrialized societies . This assumption may be due to the fact that they are the most likely to seek treatment. Recent studies demonstrate that eating disorders do affect other cultures, ethnicities and regions as well, and are possibly on the rise . However, these groups do not fit the stereotype, and more importantly, do not seek treatment as often, making it more challenging for untrained clinicians to recognize the signs and symptoms.

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Read On For More Statistics About Eating Disorders

As you can see, eating disorders impact many people from all walks of life. Know that there is help for those who are struggling with disordered eating. If you or someone you love needs support, turn to Center for Discovery. Get in touch with us today.

Barbara Spanjers, MS MFT, is a therapist and wellness coach who helps people feel more attuned with food and their body. Learn more .

What Are Eating Disorders

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Eating disorders are illnesses that affect a persons relationship with food and body image. People with eating disorders have excessive thoughts of food, their body weight or shape, and how to control their intake of food. Types of eating disorders include:

  • Anorexia nervosa, which is characterized by weight loss or maintenance by extreme dieting, starvation, or too much exercise.
  • Binge eating, which means to frequently consume an unusually large amount of food in one sitting.
  • Bulimia nervosa, with symptoms include purging, taking laxatives, exercising, or fasting to avoid weight gain after binge eating.

One may experience this as an anxious state of mind, a depressed mood, or may have a mix of anxiety and depression, says Anna Hindell, LCSW-R, a psychotherapist based in New York. Turning to control and restricting food intake or becoming addicted to binging and purging is always a symptom or effect of an underlying feeling that the person lives with. It is usually some unresolved feeling related to low self-esteem, lack of worth, or repressed trauma. People turn to the attempt at controlling food intake or eating their emotions instead of dealing with the underlying problem, if untreated.

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So What Causes An Eating Disorder

  • The shame of having an eating problem
  • The eating disorder is useful- this is a big issue for most people with an active eating problem. Purging can become a way to manage moods or to get through the day.
  • Perhaps I dont deserve to get help / I should be able to crack this on my own.
  • I am not ill enough or, there are people much more worse off than me.

National Comorbidity Survey Replication

The NCS-R sample included adults , residing in households in the contiguous U.S. Individuals who were institutionalized, living on military bases, or were non-English speaking were excluded. A four-stage national area probability sample framework was used to obtain data for the NCS-R, which was designed to be a cross-sectional replication of the original 1993 National Comorbidity Survey . The NCS-R screening interview was completed by 11,222 households, resulting in an initial 98% response rate. Interviews were conducted in person with 9,282 respondents with the mean age of 44.73 years , and a response rate of 70.9% .

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Eating Disorders And Age

  • Eating disorders can affect people of all ages and have been diagnosed in those younger than 5 years and older than 80 years .
  • Research shows that adolescents are at greatest risk, with the average age of onset for an eating disorder between 12 and 25 years .
  • 75% of people diagnosed with Anorexia Nervosa and 83% of people diagnosed with Bulimia Nervosa are between 12 and 25 years .
  • 57% of contacts to the Butterfly Foundation National Helpline in 2018-2019 were from young people aged up to 25 years .

Stereotypes Shame And Stigma

How an eating disorder develops: Madi O’Dell’s story

Stereotyping and bias aside, cultural stigma and shame around mental illness and eating disorders in Black, Asian and minority ethnic communities also prevent women from coming forward.

20-year-old Chelsea*, who is recovering from bulimia, suffered in silence for almost three years because she felt her Ghanaian parents wouldnt understand. It was only when a concerned friend raised the issue with Chelseas mum that the family was forced to address it. My dad literally told me to snap out of it and my mum insisted it must be a stomach condition because she couldnt accept I had a mental illness, she tells me. These things arent spoken about in their culture so I think they were confused and a bit scared.

Like Chelsea, Millie also experienced harmful comments from family members. When my grandmother visited me in hospital, she said to me, Stop making all this up. We get it, you just want attention, she describes. Fortunately, my mum took me seriously but so many of my South Asian friends didnt get help because they couldnt approach their families.

Dr Kanakam says more must be done to raise awareness that eating disorders can affect anyone, regardless of race, and normalise seeking help for these illnesses. Campaigns should include information about how and where to get support and give attention to early warning signs so families know when to get help, she advises.

*Name has been changed

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Initial Contact With Healthcare Services And Information

Eight of the men had been formally diagnosed with an ED. The other two identified with prolonged ED behaviours over years but neither had yet chosen to seek diagnosis. The route to diagnosis could be complex and lengthy, even when men presented late in their illness and were in need of specialist psychiatric services. Men could face a lengthy waiting list, during which time their symptoms escalated further. Even when men had made the decision to seek help, commonly someone else, typically their mother, took them to the first appointment. Usually the first contact with formal services was with their GP, although participant 3 preferred to see a locum GP because obviously didn’t have a relationship with that doctor, so that made it a bit easier to talk about stuff and I think I was so desperate anyway I just wanted to tell somebody and participant 4 chose to see the school counsellor.

Participant 1 described his first GP contact as very helpful, acknowledging his GP’s willingness to offer support, but ultimately frustrating because:Her struggle was that they haven’t got the services to give to you. They want to but they just haven’t got them. Participant 1

Only after an admission to accidents and emergency department following a suicide attempt were participant 5s problems recognised and he was immediately referred to an ED clinic for intensive outpatient treatment.

Eating Disorders And Gender

  • 63% of people with eating disorders in Australia are female and 37% male .
  • Women and girls are more likely to experience all types of eating disorders than men and boys, with the exception of Binge Eating Disorder where there is almost equal prevalence .
  • Approximately 80-85% of individuals diagnosed with Anorexia Nervosa or Bulimia Nervosa are female and 15-20% of people with Anorexia Nervosa and Bulimia Nervosa are male .
  • The gender distribution for Binge Eating Disorder is roughly equal for males and females .
  • 15% of all women will experience an eating disorder in their lifetime .
  • Eating disorders are the third most common chronic illness in young women .
  • Eating disorders and disordered eating behaviours in boys and men may present differently than in girls and women, particularly with muscularity-oriented disordered eating .
  • Research suggests that transgender people, whose assigned sex at birth does not match their gender identity, are more likely than cisgender people, whose assigned sex at birth matches their gender identity, to have been diagnosed with an eating disorder or to engage in disordered eating .
  • Research indicates that both transfeminine spectrum and transmasculine spectrum individuals had higher levels of disordered eating and body dissatisfaction than cisgender participants .
  • An Australian study found that 23% of transgender young people have a current or previous diagnosis of an eating disorder .

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Association Is Not Cause

There is no single cause for any eating disorder. This may shock some people who look for causes in childhood experiences or traumas. What we do know is that there are several known risk factors which make it more likely that a person will develop an eating disorder. And there are known risk factors for specific types of eating disorder. Someone with any kind of eating disorder is more likely to be sensitive, prone to anxiety, has high standards yet poor self-confidence. The reasons why these factors have come together in any one individual will be personal. Sometimes it is just an accident of birth and sometimes it is a build up of experiences.

Below are some of the known risk factors for eating disorders:

Eating disorders most commonly start off with dieting behaviour. You can read more about the effects and the psychology of dieting on our information page. Even though most eating disorders begin with a diet, not all dieters will get an eating disorder.

Three Out Of Four American Women Have Disordered Eating Survey Suggests

Eating disorders underdiagnosed, untreated in men, minorities
Date:
University of North Carolina at Chapel Hill
Summary:
Sixty-five percent of American women between the ages of 25 and 45 report having disordered eating behaviors, according to the results of an online survey. An additional 10 percent of women report symptoms consistent with eating disorders such as anorexia, bulimia nervosa and binge eating disorder, meaning that a total of 75 percent of American women surveyed endorse some unhealthy thoughts, feelings or behaviors related to food or their bodies.

Sixty-five percent of American women between the ages of 25 and 45 report having disordered eating behaviors, according to the results of a new survey by Self Magazine in partnership with the University of North Carolina at Chapel Hill.

An additional 10 percent of women report symptoms consistent with eating disorders such as anorexia, bulimia nervosa and binge eating disorder, meaning that a total of 75 percent of American women surveyed endorse some unhealthy thoughts, feelings or behaviors related to food or their bodies.

Although the type of disordered eating behaviors the survey uncovered dont necessarily have potentially lethal consequences like anorexia or bulimia nervosa, women report they are associated with emotional and physical distress. And despite the stereotype that eating issues affect mostly young women, the survey found that those in their 30s and 40s report disordered eating at virtually the same rates. Findings show that:

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Why Are Eating Disorders More Commonly Seen In Women

Some studies indicate that women tend to be more influenced by negative perceptions of physical appearance, as well as their susceptibility to social pressures. Objectification and sexualisation of women and gender stereotypes are also lead to the development of mental health disorders in women, including eating disorders. Though limited research has been done on this, studies have also indicated that other than cultural differences, other factors could also contribute to the development of eating disorders in women. One such study published in Oxfords journal Cerebral Cortex included 32 healthy participants with no history of eating disorders.

The experiment:The participants were made to wear a virtual reality headset that gave them an illusion of their body getting slim or obese. During the study, the participants brain was getting monitored using magnetic resonance imaging .

Results of the study: The results indicated that when the female participants were showed their obese self, there was more activity in two different parts of their brain, the parietal lobe and the anterior cingulate cortex , as compared to their male counterparts.

The scientists concluded that brain activity could be the reason for dissatisfaction with a particular body type in women. However, larger-scale studies are required to further understand the role of DNA and brain activity in the development of eating disorders in women.

Binge Eating Disorder Statistics

Binge eating disorder is characterized by frequent episodes of consuming unusually large amounts of food in a relatively short time. A person with binge eating disorder often feels binge eating is outside of his or her control and may feel shame because of it.

  • Binge eating disorder is the most common eating disorder in the U.S.
  • Nearly 3% of adults experience binge eating disorder in their lifetime.
  • American women and men experience a binge eating disorder during their lifetime, making binge eating disorder three times more common than anorexia and bulimia combined.
  • Less than half of people with binge eating disorder will receive treatment.

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How Does Anorexia Affect A Womans Health

With anorexia, your body doesnt get the energy that it needs from food, so it slows down and stops working normally. Over time, anorexia can affect your body in the following ways:

  • Heart problems, including low blood pressure, a slower heart rate, irregular heartbeat, heart attack, and sudden death from heart problems
  • Anemia and other blood problems
  • Thinning of the bones
  • Kidney stones or kidney failure
  • Lack of periods, which can cause problems getting pregnant
  • During pregnancy, a higher risk for miscarriage, cesarean delivery, or having a baby with low birth weight

Anorexia is a serious illness that can also lead to death. Studies have found that more women and girls die from anorexia than any other eating disorder or serious mental health problem such as depression. Many people with anorexia also have other mental health problems such as depression or anxiety.

Long-term studies of 20 years or more show that women who had an eating disorder in the past usually reach and maintain a healthy weight after treatment.

Sample And Participant Characteristics

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Sample size

Apart from the online survey study that had a larger sample size , all the other qualitative studies had sample sizes between 5 to 15 participants.

Participant age

In all but one study , the age of participants were documented, with participants reported to be between 16 to 58 years.

Gender

In the studies included in the metasynthesis, 5 had only male participants , 3 had only female participants and focused on gender issues in treatment and one study explored the treatment experiences of transgender that had female, male and non-binary participants.

Type of eating disorder

The studies comprised of participants diagnosed with AN , AN, BN, BED and EDNOS , AN, BN and BED , only AN and BN , and two studies did not specify participants ED diagnosis.

Sexuality

The studies included people who identified as heterosexual, bisexual, Bi/pansexual female , only female where sexual orientation was unknown , only heterosexual male , hetero and gay males , and female, male and non-binary participants .

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Body Image Dieting And Social Media

  • Body image has been listed in the top four concerns for young Australians from 2009-2018 with 30% concerned about body image .
  • Research shows that up to 80% of young teenage girls report a fear of becoming fat .
  • Nearly 23% of Australian women report a self over evaluation of weight and shape meaning they think they are larger than they are according to BMI .
  • It has been reported that more than 55% of Australian girls and 57% boys aged 8 to 9 years are dissatisfied with their body t .
  • Nearly half of Australian women and one third of Australian men are dissatisfied with their body .
  • Weight related teasing in children is associated with disordered eating, weight gain, binge eating, and extreme weight control measures .
  • Social media use has been linked to self-objectification, and using social media for merely 30 minutes, a day can change the way you view your own body .
  • A study of teen girls reported that social media users were significantly more likely than non-social media users to have internalized a drive for thinness and to engage in body surveillance .
  • Weight-loss dieting is a risk factor for the development of an eating disorders and. Dieting frequently precedes the onset of an eating disorder .
  • Dietary restraint influences binge-eating behaviour .
  • High frequency dieting and early onset of dieting are associated with poorer physical and mental health, more disordered eating, extreme body dissatisfaction, and more frequent general health problems .

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