The fact that the majority are from Argentina and Mexico is not surprising, considering their large populations and their active feminist scenes organizations, magazines, etc. Also, in examining Mexico, we need to consider the influence of its neighbor, the United States, which has its own highly feminist sensibilities. Interestingly enough, the majority of these texts have yet to be translated into English, or even recognized outside the countries where they were published, for that matter.
The second question I am often asked is if there is even an issue with weight in Latin America. This question is much more complicated to answer than the first.
Revista Mexicana de Trastornos Alimentarios - Mexican Journal of Eating Disorders
However, the fat they love is concentrated in specific parts of the body, specifically large breasts, wide hips, and curved rears. It is clear, from reading Latin American magazines and watching television, that the beauty image consistently promoted in these outlets is that of a young, thin woman.
The only exception seems to be the archetypal mother, grandmother or trusted maid in the soap operas, given acceptance as fat and lovable. Women today face a cruel conundrum. On the one hand, they are still expected to be the principal providers of nourishment for their families; therefore, they must stay close to food. Generational differences appear in the ways various Latin American authors approach female size issues.
Consider the aforementioned Como agua para chocolate , a text that popularized food discourse in Latin America. Set on a ranch on the Mexican-U. And yet, the notion that only the young and slender body is attractive to men contrasts drastically with her attempt to put forth a feminist narrative. Afrodita Aphrodite, , by bestselling author Isabel Allende, is a light and humorous book of personal anecdotes, literary texts and cooking recipes that exhorts women to abandon their inhibitions and pursue the pleasures of the flesh.
Allende repeatedly laments not being able to enjoy the delicious desserts she includes in the book because she does not want to gain weight. Authors born since the s, however, forcefully argue against a society that diminishes and marginalizes the large body instead of focusing on resolving more pressing social and economic problems, such a family dysfunction and poverty.
Hence, in this sagacious story, the gazed upon—normally the woman—becomes the gazer. The story also reiterates the prevailing double standard for women and men when it comes to weight. Perez et al. Racial and ethnic minority women who live in the U. This process of adjusting to U. This stress is called acculturative stress. Although the body of research examining links between acculturative stress and eating pathology remains small, trends suggest that increased acculturative stress is linked with increased eating-related pathology for Latinas.
Similarly, in a sample of adolescent Latinas, acculturation, measured by primary language Spanish or English was not related to the prevalence of amenorrhea, dietary restraint, bulimic symptoms, or low BMI Granillo et al. These findings suggest that ethnic minority women who are experiencing acculturative stress may be susceptible to decreases in self-esteem and increases in eating pathology.
Further, for women who are presenting to clinical settings with disordered-eating concerns, assessing and addressing acculturative stress and self-esteem may enhance the cultural sensitivity of treatment Claudat et al. Accurately identifying Latinas with disordered-eating behaviors is an important first step in providing helpful intervention. Unfortunately, several patient and provider barriers may hinder accurate, prompt identification and referral of individuals suffering with eating disorders.
Patient barriers may include mental health stigma, access to care, and awareness and distress associated with disordered-eating behaviors. Provider barriers may include bias in assessment and lack of accurate illness representation in diagnostic criteria. Patient variables. Higgins and colleagues compared two groups of Latinas in terms of their self-identification as having a history of disordered eating.
Those who did not identify as having a history of disordered eating were less likely to have experienced anorexia or bulimia nervosa versus binge-eating disorder or other specified feeding or eating disorder; Higgins et al. These results may suggest that those diagnosed with binge-eating disorder or other specified feeding or eating disorder did not perceive the associated behaviors as disordered or were unable or unwilling to acknowledge having an eating disorder. Similarly, in a national epidemiological survey of Latino households in the U.
Provider variables. Clinicians working with Latinas should take care to assess eating-disorder symptoms in their patients in a manner that is culturally sensitive. Some research has documented that a bias exists both in the general U. One study found that U. Consistent findings have emerged with clinician samples. Becker and colleagues reviewed data from 9, participants in a two-wave educational and screening program for eating disorders. These data sets suggest that clinician bias may interfere with timely identification of eating-disorder symptoms.
In addition, some scholars have questioned whether our current diagnostic criteria accurately represent the illness presentation of Latinas with eating disorders.
More Ethnic Minorities Are Suffering From Eating Disorders
Alegria and colleagues point out that, in their national epidemiological survey of Latino households in the U. For example, only six out of individuals who had lower than normal weight-to-height ratios endorsed intense fear of gaining weight, a symptom that is part of Criterion B for Anorexia Nervosa American Psychiatric Association, In addition, only eight individuals out of the endorsed body dissatisfaction. Similarly, although binge-eating behaviors occurred at an elevated rate in this population, requiring as part of the assessment that both binge-eating and compensatory behaviors occur concurrently and weekly for several months decreased the number of individuals who would have been identified as having Bulimia Nervosa Alegria et al.
Binge Eating Disorder BED , which accounts for binge eating episodes without concurrent compensatory behaviors, was formally recognized as an eating disorder in the DSM 5, and should be carefully considered when assessing disordered eating behaviors in Latinas in the U.
Several overarching themes emerged from this review. First, eating disorder pathology, eating disorder symptoms, and eating disorder risk factors occur in Latinas at significant rates and across childhood, adolescence, and adulthood. This is an important finding because the widely held stereotype that eating disorders only occur in White women continues to pose barriers to identification of eating disorders in racial and ethnic minority women. Acculturative stress appears to influence the degree to which Latinas experience eating disorder symptoms.
Women who experience increased stress in their efforts to negotiate differing values regarding weight and shape between their cultures of origin and broader U. Thus, clinicians should, when appropriate, assess acculturative stress and explore whether any changes in eating, shape and weight concerns, self-esteem, or other weight management behaviors might be related to efforts to comply with larger U.
Finally, both patient and provider barriers may hinder the recognition of eating disorders in Latinas.
Regarding provider bias, the findings underscore the importance of routinely assessing for the presence of eating disorder symptoms when working with Latinas. Further, as stigma plays a role in the help seeking behaviors of Latinas in the U. Lauer, M. Identifying eating disorders in Latinas: Racial and ethnic bias in care. Psychotherapy Bulletin, 52 3 , Alegria, M. Prevalence and correlates of eating disorders in Latinos in the United States.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. Washington, DC: Author. Barry, D.
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Eating and body image disturbances in adolescent psychiatric inpatients: Gender and ethnicity patterns. Becker, A. Ethnicity and differential access to care for eating disorder symptoms. Berry, J. Assessment of acculturation. Berry Eds. Cachelin, F.
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