Eating Disorders Crossing the Color Line

Monday, March 28th 2005, 9:40 am

By: News On 6

MONTGOMERY, Ala. (AP) _ The common perception is that eating disorders afflict only white women, especially upper- and middle-class women. While those are the most reported cases, specialists believe all socio-economic and ethnic groups are at risk.

For Liza LeGrand, it all started with anorexia in her early 20s, self-starvation that later included episodes of gorging on food and purging. At 5-feet-2, she got down to 70 pounds. LeGrand is Puerto Rican and dealing with what many believe is a ``white woman's'' problem.

``For so long there was the belief that eating disorders only involved young white women,'' said Gayle Brooks, a black psychologist specializing in eating disorders at the Renfrew Center in south Florida where LeGrand was treated. ``What they saw were exclusively white women with the problem.''

Black and Hispanic women were thought to be less likely to develop anorexia and bulimia because more voluptuous physiques are generally considered attractive within their ethnic groups. A study in the Journal of Counseling in Psychology in 2001 found that African-Americans were more accepting of larger body shapes and less concerned with dieting.

Margaret Garner, nutrition director at the University of Alabama's medical center in Tuscaloosa, said this view was expressed frankly in a graduate class in health. In the past 25 years, she has counseled only one black woman with an eating disorder. She asked her class why the number of reported cases among black women was so low.

``An African-American male student readily said that he thought the reason there were no black females with this problem is that black men preferred some meat on the bones of their girlfriends and white men preferred them boney,'' Garner said.

But Laurie Mintz, an associate professor of counseling psychology at the University of Missouri-Columbia, said adoption of ``Western values concerning attractiveness and thinness may increase minority women's risk for the development of eating disorders.''

Research over the last decade has found these eating disorders among minority women and lower-income women, she said. Increasingly, anorexia and bulimia may be becoming ``an equal opportunity disorder,'' Mintz said, citing other researchers.

According to the National Eating Disorders Association, there are no reliable statistics on the prevalence of eating disorders among minorities, but diverse communities are underrepresented in the research.

Brooks suggested several reasons for the invisibility of minority women suffering from eating disorders:

_Because minority and poor women don't fit the profile, doctors and therapists often fail to assess them properly for eating disorders.

_Education efforts haven't been directed toward ethnic groups, so family and friends often miss the early signs.

_For some poor women, it may be hard to get adequate treatment.

Stephen Thomas, director of the Center for Minority Health at the University of Pittsburgh, says he has met only one African-American with anorexia.

``Other than the color of her skin, she matched her middle-class white counterparts when it came to the important factors associated with the disease,'' he said.

He is concerned that these eating problems may increase as health agencies target overweight minorities. Two-thirds of Americans are overweight or obese, and the percentages are higher among blacks and Hispanics.

``As the nation becomes focused on obesity as a national obsession, we must be aware of unintended consequences,'' said Thomas. ``We do not want to create conditions to contribute to eating disorders in our zeal to address obesity.''

Mintz also says complex cultural issues must be weighed in considering risks to different ethnic groups.

``In other words, the complex issues that may result in an eating disorder in a 15-year-old middle-class white girl, such as pressures to be thin, struggles with independence, may be different than the complex issues that may result in an eating disorder in a second-generation 15-year-old Korean-American girl,'' who may want to separate from her parents and eat more ``American'' like her friends.

The longer eating disorder sufferers go without treatment, Brooks says, the more it could become a chronic problem leading to death.

LeGrand knows how life-threatening it can be. The 36-year-old Orlando, Fla., resident was hospitalized for a month in 1998 because of the damage her purging did to her body. While she has been admitted into two treatment centers in the past, she continues her struggles with her disorder.

The first time LeGrand was admitted to a treatment center was while she was attending a university in Michigan.

``The dean somehow found out and they called my parents and told them,'' LeGrand says.

She says she felt betrayed and her experience at the first clinic did not go well.

A patient at the Renfrew Center in Florida in 2001 and 2002, she says her treatment there has been helpful. Now a mother, LeGrand is currently on disability because she has diabetes along with the eating disorder.

She said she did not binge or purge during her pregnancy and for a few months after out of concern for her child, but she eventually returned to the behavior she has tried so hard to put behind her.

``There are moments, of course. Everyone has their days, but now I know how to control it,'' she says. ``I'm a lot stronger.''