Latinas Have Unique Risk Factors for Eating Disorders

Having worked as an eating disorder dietitian and being in recovery from an eating disorder myself, it’s clear to me that Latinas face unique risk factors for eating disorders—things like trauma, conflicting beauty ideals, and mental health stigma. Yet, research on eating disorders in Latinas remains drastically minimal and changes are necessary to improve eating disorder care for Latinas. Traditional treatment isn’t accessible or appealing to many Latinas since it’s expensive and often lacks diversity and cultural humility, and that’s if Latinas even realize they have a problem and take the scary step to seek support. The misconception that eating disorders only affect young white women prevails despite eating disorders affecting all sorts of people. As a result, our community suffers. I spoke with two Latina eating disorder experts to get their thoughts on how eating disorders uniquely impact Latinas and the changes necessary to better care for our community.

Latina Risks for Eating Disorders

There are thousands of studies on eating disorders, but most of them are conducted on young white women. This is a problem because eating disorders don’t discriminate; they affect all kinds of people, including Latinas.

Of the research we have, a 2019 study in Eating Behaviors found that amongst young women, there were no ethnic differences in eating disorder prevalence. A more recent study from 2022 in Current Opinion in Psychiatry found that Latinx adolescents and adults tend to have lower rates of eating disorders compared to their non-Latinx white counterparts.

However, Latinxs seek treatment for eating disorders less often than non-Latinx white individuals. This could be due to the high cost of eating disorder treatment, lack of health insurance coverage, and stigma around eating disorders and mental health in our community. Lots of Latinxs likely go undiagnosed since there’s not much awareness of eating disorders in Latin culture. That being said, we have some serious risk factors for eating disorders.

Unique Eating Disorder Risk Factors for Latinas

Appearance-Based Nicknames

Have you been called “gorda”, “flaca”, or any other nickname related to your body size? Even if you haven’t, you may be thinking of a cousin who has. These types of nicknames are super common in our culture, and they can cause real harm for those who are struggling with eating or body issues.

A 2019 study in the Journal of Psychosomatic Research found that weight-based teasing is linked with more unhealthy weight control behaviors and worse emotional health in Latinxs. Naomi Tapia, a therapist specializing in disordered eating, says that she’s worked with many individuals who say that these nicknames have fueled their eating disorders. “I’ve found that so many individuals — myself included — I’ve worked with remember these nicknames, i.e. ‘gorda’, ‘flaco’, ‘chaparra’ etc., and can admit that these fueled their eating disorders,” she tells HipLatina.

Discrimination

Whether it be due to skin color, accent, language, or ethnic background, discrimination can wreak havoc on mental health. For someone at risk for an eating disorder, this can further heighten their risk. A 2023 study in Current Opinion in Psychiatry found that ethnic or racial discrimination predicts eating disorder symptoms, even in people who are proud of their ethnic background.

Trauma

Eating disorders are heavily linked with trauma. In fact, Tapia says that about 90 percent of her clients are survivors of sexual trauma. Many of them fear disclosing this information to their families, which she says often correlates with future development of an eating disorder. “This is because when people experience sexual trauma, they learn that being in their bodies is not safe, and therefore they disconnect. Often this disconnection ‘allows’ them to hurt or damage their body because they do not feel tied to it,” she explains.

The immigration experience can be another traumatic experience that can cause a bunch of challenges with self-esteem, relationships, and eating. “I have worked with many clients who do not want to burden their families, feel they have to suppress their own needs to meet the expectations of others, feel they are undeserving of care, or may not recognize their own struggles because it has been so normalized in their culture and sometimes family lineage,” Christina Figueroa, a Colombian eating disorder and sports dietitian at Cornell Health, tells HipLatina.

Unrealistic And Conflicting Beauty Ideals

The “ideal body” touted in U.S. media is not the same as the “ideal body” we see in Latin American media. Typically, Latina beauty ideals involve curvy, voluptuous bodies with tiny waists, while beauty ideals in the U.S. are rooted in thinness and whiteness. “Many Latine folks struggle with finding the balance in their bicultural identity, which sometimes leads their pendulum to swing into extremesm Tapia says. The pressure of these beauty ideals can lead to body dissatisfaction which is linked with eating disorders.

Mental Health Stigma

Although it’s improving, there still isn’t much awareness of mental health in Latinx culture. As a result, there can be stigma and shame around struggling with your mental health, and mental health issues may be dismissed by your loved ones.

“Many Latin American countries are not as open to discussing mental health concerns which may perpetuate stigma, shame and guilt, and lead to people hiding their struggles,” says Figueroa. This can prevent Latinxs who really need treatment from acknowledging their issue and seeking help.

Change Is Necessary To Better Support Our Latine Community

“Having more research means more awareness, ideally more evidence-based care, potentially less stigma as it becomes more widely discussed and understood, better education and training of clinicians, etc., which ideally would translate into eating disorder prevention, better identification, more broad support, and better treatment outcomes,” she adds.

The 2022 study in Current Opinion in Psychiatry found that Latinas who were more acculturated to the white majority culture of the U.S. found treatment more helpful than those who were less acculturated. But Latinas shouldn’t have to give up their culture to access treatment that works. Part of the issue is that we don’t have much research on what treatment adjustments would best support Latinas.

One worthwhile consideration is inclusion of cultural foods. “Treatment can feel inaccessible when our foods are not taken into consideration and people are told/suggested to eat in certain patterns or with primarily Eurocentric foods,” Figueroa tells us.

Other changes that Figueroa and Tapia say could make a big difference include having more representation amongst eating disorder providers, learning from Latinas’ lived experience, celebrating our cultural foods, and breaking the stigma around weight and mental health topics in our community.

That same study found that culturally adapting treatment with family sessions helped reduce eating disorder symptoms, and the family aspect helped improve treatment retention and adherence. Cultural adaptations included things like offering sessions in Spanish, incorporating Latin values like familismo and respeto by including the whole family in treatment, and incorporating ancestral consejos into treatment.

On that note, Tapia believes that focusing on community care could go a long way for supporting our community since our culture is more collectivist than individualistic. “I’ve seen Project HEAL’s new community care program (Body Reborn) do such an incredible job supporting folks struggling with EDs.”

While we have a long way to go, more studies are in fact being published on eating disorders in Latinas. Hopefully, as we get more research, diagnosis and treatment will evolve to meet the needs of our community and others who have been traditionally overlooked in the eating disorder field.

If you or someone you know is struggling with an eating disorder, contact an Eating Disorder Helpline for support, resources, and treatment options.

Isabel Vasquez is a second-generation registered dietitian of Puerto Rican and Dominican descent dedicated to an anti-diet approach and embracing cultural foods.