Health
Cultural bias leaves gaps in eating disorder diagnosis
Chita Gastelum, an immigrant who identifies as indigenous and Latino, remembers coming to the United States and growing up under American diet pressure.
“It’s kind of a culture shock,” she said. As a “curvy” woman, Gastelum found that Americans have different standards of acceptance. “I understand the harm it can cause, especially to women from other countries who are just trying to live an American life,” she said.
Eating disorders are on the rise In the United States, including teenage girls. Women are more likely to suffer from eating disorders such as bulimia and anorexia, but research, diagnosis and treatment are lagging for men, LGBTQ, Latino and black women.
Medical professionals are looking for better screening methods to better understand people who develop eating disorders. According to the National Eating Disorders Association, 20 million women and 10 million men in the United States will develop an eating disorder during their lifetime. Nutrition education, psychotherapy, and support groups continue to be ways of treating symptoms that are difficult to get rid of.
Gastelam, 52, who was diagnosed with an eating disorder after being at high risk and has been in remission for 20 years, said people with eating disorders felt the need to restrict their diet and ultimately focused on food and healthy eating. said it might come to put pregnancy.
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“If you don’t attend events, you start to isolate yourself,” says Gastelum, a former Mexican resident who lives in Tucson. “You are withdrawing from your normal social activities and really limiting yourself. It also creates a lot of anxiety.”
Eating disorders do not discriminate.
“I think the most important message is that eating disorders can affect people of all genders, all sexual orientations, all ethnicities, all races and all sizes,” says University of California, Sun. said Dr. Jason Nagata, assistant professor of pediatrics. Francisco. “It’s important to understand that you can’t tell someone has an eating disorder just by looking at them. Eating disorders vary.”
Men develop eating disorders that are often underdiagnosed
Symptoms of eating disorders in men are often overlooked or unrecognized, making proper diagnosis and treatment difficult, Nagata said. “We don’t have an equivalent formal diagnosis that captures the experience of men,” he said.
The fact that men struggle with eating disorders may mean they’re pushing for bigger physiques in order for society to reflect the link between masculinity and muscle. Men may overeat large amounts of food at once, consume protein while limiting carbohydrates and fats, take large amounts of supplements such as steroids, and engage in excessive or compulsive exercise. Nagata said there is.
“Some people start going to the gym all day and are obsessed with their appearance,” says Nagata. “After a certain point, it becomes obsessive and obsessive, and spending time outside the gym and not eating a high-protein diet is stressful and impairs quality of life.”
Binge eating is uncontrolled, rapid eating of large amounts of food at least once a week for at least 3 months.
This is known as “muscular dysmorphia,” but it is also called “oblique or reverse anorexia.” The person might be normal sized or even thought to be muscular, but they don’t see it.
“Maybe they’re trying to gain muscle and get bigger, and they’re trying to achieve that by participating in supplements and muscle-building activities,” says Nagata.
Eating disorders in men also take longer to diagnose and are at higher risk of health complications and death, according to eating disorder groups.
“I think the typical screening questions for primary care physicians and pediatricians often focus on weight loss,” says Nagata. “You may be asked about behaviors such as fasting, skipping meals, severely restricting food intake, vomiting, and taking laxatives or diuretics to lose weight.”
Eating disorders have also been feminized, such as diagnoses that link eating disorders with loss of menstruation. Nagata said the gender-biased diagnosis has since been abolished.
However, stigma remains and may deter men from seeking treatment.
Nagata said he believes more research and categories are needed to better understand concerns about body image issues in men and boys. “Whether it’s a concern about muscle mass or a concern about exercise, really figuring it out can help us identify those who are suffering,” he said.
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Most people diagnosed with anorexia and bulimia are women, and two-thirds of teenage girls across the country report actively trying to lose weight, Nagata said. “I think this just reflects some of the pressures that exist for various social and cultural reasons.”
Ms Gastelam said her family was unaware of her eating disorder, but believes it may have started when she was 15. “Because of my culture, eating disorders don’t exist,” she said.
Ms Gastelam said her mother also struggled with the pressure to lose weight. “Her mother didn’t know she had an eating disorder, but I saw signs of it in her too,” she said.
While most research focuses on cisgender women, a 2020 study found that Eating Disorder Journalstates that “lesbian, gay, bisexual, and transgender adults and adolescents are more likely to experience eating disorders and disrupted eating behaviors due to the stress of stigma and discrimination.”
“Transgender youth are known to have a very high prevalence of eating disorders, especially due to discrepancies in their gender identity and the gender they were assigned at birth,” Nagata said. “And eating disorders and body image can go hand-in-hand with a lot of issues.”
Race also affects whether people get help.
As with other clinical trials, women of color were excluded from the study, according to the U.S. Department of Health and Human Services.
That’s because of prejudice, says Gastelum. People who fit the white, skinny, or cis woman body image are more likely to be appreciated.
“It’s really harder for BIPOC people than white people to even be asked about their eating disorder symptoms,” she said, briefly describing blacks, indigenous peoples, and people of color.
The National Eating Disorders Association reports that black women are significantly less likely to be offered treatment than white women with the same symptoms.
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Treatment focused on controlling emotions
Clinical treatment centers offer a wide range of services ranging from psychotherapy to help manage eating disorders, nutrition education and community support.
April Vanslet, clinical director and founder of the Woodleaf Center for Eating Disorders in San Francisco, has been treating patients in an intensive outpatient facility since 2007. The center helps treat anorexia, dieting, bulimia, and bulimia and hosts online and in-person programs.
“We’re focused on the psychotherapeutic part, not the nutrition,” Vanslet said.
It’s easy to become overwhelmed during treatment for an eating disorder, she says. “We’ve found that some people don’t even go to therapy because there’s too much emphasis on diet and not enough systemic underlying emotional reasons for it to exist.”
Vancelet said the goal of personalized therapy is not just to cure symptoms. That is why they approach treatment by asking questions such as: How does it help?
Vancelet said that for most people, emotional regulation is at the root of eating disorders.
“People with eating disorders use their eating disorders to control their emotions, such as anorexia, bulimia, binge eating, binge eating, and purging,” she says. “That’s kind of the core.”
Gastelam, a family guidance expert at online telemedicine service Equip Health, said she hopes to see more education about eating disorders.
“But that’s what I’m hoping for: eating disorders will decrease and more health care providers will learn about eating disorders and know the signs of treatment. So I hope it will.” .”
Gastelam said one of the biggest steps to recovery is talking to someone you trust or finding a community support group.
“If you’re struggling with an eating disorder and you’re not sure about it,” says Gastelum. “Being able to put your feelings into words is important because we live in a society that teaches us not to express our emotions.”
“My message is don’t be afraid to speak up. Don’t be afraid to reach out as it will make a big difference.”
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