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
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
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
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.