PRINCETON, New Jersey — The study of eating disorders (EDs) has historically focused on socioeconomically affluent communities. However, recent research indicates that EDs have less to do with being an accessory of privilege. Instead, EDs have more to do with the psychological and emotional connections that people have with food. As such, EDs and food insecurity are heavily correlated. This puts communities that face erratic and troubled relationships with nutrition at a higher risk of developing disordered eating afflictions. This is especially true for those who experience food scarcity.
Eating Disorders: What are They?
Defining EDs is complex work as their aesculapian contexts are constantly changing. Most commonly EDs are identified through common symptoms such as behavioral patterns. The American National Institute of Mental Health broadly characterizes EDs as a medical illness. According to the Diagnostic and Statistical Manual of Mental Disorders, the four diagnoses of EDs are anorexia nervosa, bulimia nervosa, binge-eating disorder and any other unnamed EDs. These can include behaviors such as avoidant and restrictive food intake, often linking to external stress and psychological factors. Disordered eating is designated as a less severe form of EDs. However, disordered eating increases the susceptibility of an individual’s proximity to more severe EDs.
The Psychology of Disordered Eating
Disordered eating is connected to mental pressures, stress and cognitive functioning. There is a clear correlation between starvation and psychological behaviors with diet having a heavy influence on the brain. In an interview with The Borgen Project, a third-year doctoral student at the University of North Carolina Rachel Uri explained how her Clinical Health Psychology Program is utilizing a holistic approach in understanding how these behaviors work.
“In thinking about those who experience persistent food insecurity and deprivation over time, [it is known]that nutrition and adequate nutrition is super important for healthy brain development,” said Uri. Additionally, “food insecurity causes a great deal of stress for people that are experiencing it, and poverty in general and those competing basic needs that have to be attended to.”
Those living in scarcity may have poor eating patterns that are not connected to EDs. Such patterns include semi-starvation or the habit of eating less in case food supplies run out. Identifying EDs and food insecurity as correlative with stress heightens the connection vulnerable groups have with food insecurity.
How Attitudes Around EDs are Changing
For an extensive period of time, western media and academia placed the focus on understanding EDs in developing countries. This interpretation was especially connected to America’s fascination with eating behaviors that burgeoned in the 1990s. It ran parallel with the portrayal of skinny television stars who were portrayed as the beauty standard. The connection of EDs to high-income women was also shaped by the sentiment that it stands as an issue of abundance, rather than stress.
Though these attitudes may have been common, they were largely misdirected. The same 1995 Newsweek Report study concluded that high-income, white girls were predominantly discontent with their body, findings on women of color were downplayed. Findings were arranged to perpetuate the notion that they were confident in being shapely.
New findings are proving that EDs and food insecurity affect all demographics and ethnicities at similar rates. The impact of the long-standing stereotype of the high-income populations being most affected has incredibly dangerous implications on communities of color. Apart from being introspectively displaced on the compass of EDs, patients are statistically proven to receive different types of quality care depending on their race. People of color in the U.S. are less likely to receive help for EDs than their white counterparts. However, they are just as likely to be affected.
Eating Disorders Around the World
In the same way that EDs are narrowly detailed in the west, they are also massively overlooked within the context of global poverty. Inquiries into finding a correlation between socioeconomic standing and disordered eating have yet to be unpacked. However, there are a few studies that have discovered some connections.
A study conducted in Australia indicated that indigenous communities in New Zealand are not exempt from EDs though they are disadvantaged in the medical and health system. Uri explains that “looking at it from a global perspective, American researchers and European researchers as well have to be cognizant of the fact that the way we study food insecurity in [countries around the world]is not a one-size-fits-all approach.”
Though there is a distinct trend of rising EDs throughout continents such as Asia and South America, they are typically comprehended through a scope that treats western EDs as the normative standard. Pointing to urbanization as the core factor is designated as a biased analysis. It incorrectly places the focus away from how EDs are connected to the cultural contexts in which they develop.
That’s not to say symbols imported by global influence have no cultural impact on EDs. Throughout many Asian nations, EDs are identified as reactionary toward western media. In the same spike of attention on body image in the 1990s, television media became globalized. The unrealistic body standard interfered with several cultures that had previously standardized larger bodies as signs of wealth and status. Body dissatisfaction could have very well been introduced from abroad. However, unrealistic standards are facilitated by the communities in which they grow.
Food Insecurity, Food Justice and Food Agency
In the oncoming direction to connect disordered eating with food insecurity, there is a sense of urgency to apply this understanding globally. The resolution to end world hunger is customarily seen as one that fights food scarcity. However, those who receive nutritional aid are limited in the types of dietary options they receive and the consistency in which they receive it. Food justice nonprofit organizations are starting to highlight this obstacle to ending world hunger. Not only is the food itself a precious subsidy but the relationship between food and those living in food scarcity is a priority as well.
Uri stated this integrated approach is “what’s been termed more recently as “food agency.” That is the concept of communities exercising control over the creation, distribution, preparation — from when the crop grows on the ground to when it’s on [the]table. Having control, choice, autonomy in getting those things.” Nongovernmental organizations (NGOs) are likely to follow food agency models in the coming years. They now have the awareness that food justice includes more than delivering food to those who need it; it is about providing the right tools for vulnerable communities to grow and develop their own nutritional food.
Addressing Global Hunger by Improving EDs Studies
Although there is an extensive amount of work to be done in deconstructing the degree and angles of identifying EDs and who they affect, articles have begun shifting the attention to all populations, regardless of socioeconomic status. This shift is important as it indicates a growing trend in correcting the course of how EDs had been diagnosed and approached. Additionally, the attention commits an obligation to resolve the issue of EDs as a food insecurity issue.
Through tackling mental health as an issue that affects developing nations, the growing trends of EDs can likely be resolved. The attention on mental health in developing countries remains a low priority. The World Health Organization calls for more resources to go into tackling mental health issues abroad as they are growing in number and severity. But, while psychology experts recommend exercises such as meditation and yoga to alleviate stress, a more systemic pattern and significant solution are required for those who live in food scarcity to overcome their stress.
Individuals Helping Connect EDs to food security
Few U.S. nonprofits have begun incorporating disordered eating in their model to fight food insecurity. Individual experts in nutrition, poverty, food security and disordered eating are advocating for a change to this. Along with Rachel Uri, other academics and doctors are calling for disordered eating to be recognized as a priority of food justice.
Kimberly Singh with the Eating Disorder Registered Dieticians and Professionals has worked to assist refugees with community-based solutions in overcoming food insecurity. Dr. Carolyn Black Becker, former president of the Academy of Eating Disorders, is also bringing to light how the stereotypes surrounding EDs have an impact on food insecurity. Becker also spoke at an academic symposium on the issue. She presented a model to understand EDs in the context of food scarcity with her colleague, Dr. Keesha Middlemass. Lastly, Dr. Fatima Cody Stanford at Harvard University has made significant contributions to this movement as well. She points to the impacts that the novel coronavirus has on food insecurity, increasing the vulnerability of disordered eating symptoms.
Understanding EDs and food insecurity as interconnected issues is a new topic in the field of western academia. The impact of this awareness will likely influence the approach and model that food justice organizations use. The best solution is, as Uri puts it, a self-sustaining system for organizations to deliver food agency to individuals and communities living in food scarcity. Self-sustaining systems are long-term solutions for food aid. The conversation is rapidly growing, and it must include global matters as well.
– Danielle Han