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The Changing Face of Anorexia

Anorexia is getting older – and younger – and not just white and female. What's going on?

Anorexia Is Getting Younger, Too continued...

One heartbreaking challenge to diagnosing these girls: a key diagnostic criterion for anorexia is the loss of menstrual periods, but more and more of these girls are too young to have even had a first period yet.

Besides age, ethnicity is a telling factor in current cases of anorexia. "For Caucasian and Hispanic girls and women, the rates of anorexia are basically indistinguishable," says Bunnell. "On the other hand, there does seem to be some protective factor from anorexia if you're African-American."

Studies have indeed found very few African-American women with anorexia, compared to white, Asian, and Hispanic women. But that doesn't mean that they are free from eating disorders.

"African-American women have been found in some research to have higher levels of laxative abuse for weight control even than white women, which was surprising," says Gayle Brooks, PhD, vice president and clinical director of the Renfrew Center in Florida. "We see high levels of diuretic use as well." Young black women, in short, are more likely to be "bingeing and purging" than they are to be starving themselves with anorexic behavior.

That, too, may be changing. African-American women do get anorexia. A 2001 study, for example, found that 2% of African-American women at a large Midwestern university had the disorder. Kaelyn Carson, a 20-year-old college cheerleader and track star from Michigan, died in the summer of 2001 after a 14-month battle with anorexia.

"Whatever sort of protective function comes from being very culturally connected dissipates over time as pressures rise on women of color, as they do white women, to have their self-esteem determined by body size," says Brooks.

She adds, "the protective qualities of culture become much less influential when a young girl goes into a predominantly white environment, where she's assaulted with images and pressure to look a certain way."

Anorexia: Not Just a Woman's Problem

In the mid-1980s, experts believed that women with anorexia outnumbered men by a factor of 10 to one or more. But in 2001, a Canadian study published in the American Journal of Psychiatry found that female anorexics outnumbered males by only four to one.

"There are a number of treatment centers in the country that specialize in treating men and boys with anorexia, and they seem to be seeing an increase in demand," says Bunnell. Is that because there's been an increase in male anorexia, or simply because doctors are finally recognizing the disease in men? "It's probably a little bit of both."

In 2003, a BBC survey of child and adolescent mental health specialists in Britain found that nearly three-quarters believed that anorexia is underdiagnosed, and not well understood, in males.

What's more, there's no doubt that the pervasive societal pressure about body image has been extended, more and more, to men. For proof, look no further than your nearest magazine stand, where you'll find numerous men's magazines featuring the same kind of unrealistically perfect models that have traditionally been found in Vogue and Cosmo.

"Boys and men are now subjected to increasingly unrealistic expectations about what they should look like, and mixed in with the national antiobesity push, we're seeing more and more tension in boys about their physical appearance," says Bunnell.

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