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Beyond the Mirror: The Social Roots Behind Eating Disorders 

by Zayaan Tirmizi

Eating disorders are among the most prevalent and underdiagnosed illnesses that Americans live with on a day-to-day basis. Nearly 30 million Americans deal with anorexia or related eating disorders. Framed as ordinary illnesses, and routinely underdiagnosed, eating disorders are far from normal pathologies. Often shaped by societal expectations and norms, these disorders affect patients on both a mental and physical level. Consequently, those who are suffering are often forced to deal with symptoms that transcend psychological boundaries and can even face health consequences that could be fatal if left untreated. 

Significant research is still necessary to examine the factors that contribute to these conditions. Physicians have argued for a variety of reasons, ranging from genetics to the rise of social media and shifting expectations, particularly for women. One of the factors that remains largely unexplored is the effect of socioeconomic factors on these eating disorders. 

Traditionally, society has often placed eating disorders within a category termed “diseases of affluence.” This leads to a dangerous misconception that those who are in lower socioeconomic categories are somehow less commonly afflicted with eating disorders than their wealthier counterparts. However, these stereotypes can be harmful, as they deny access to groups of society that may require the most treatment, with new research indicating that people from lower socioeconomic backgrounds tend to suffer disproportionately from eating disorders. Behaviors such as vomiting and misuse of diet pills, laxatives, or diuretics to reduce weight are reported at higher rates among women in these groups. While these isolated behaviors do not indicate eating disorders in and of themselves, they are often symptoms that can lead to eating disorders if they have not already escalated to that point. 

Low socioeconomic strata suffer uniquely from eating disorders for multiple reasons. Research from the Copenhagen University Hospital has showcased that family dynamics, including parental socioeconomic status and familial eating disorder history, contribute significantly to rates of incidence amongst children. Parents who are within lower socioeconomic strata often possess lower levels of education due to the impoverished environment in which they were raised. In school districts with lower funding, education is often underfunded and the curriculum generally does not contain extensive education on lifestyle choices. This translates to poorer nutritional awareness within these groups and a higher incidence of health-related problems. Eating disorders do not evade this trend, and the higher rates are present across these lines of wealth. Additionally, the family structure that plays a major role here indicates that parents who are suffering from eating disorders may influence their children to partake in the same activities. Given that children observe unhealthy eating patterns from a young, malleable age, they are significantly more likely to adopt those practices as norms. 

Of course, the issue of food insecurity itself is also detrimental to forming healthy eating habits in these populations. Food insecurity means that a stable source of food is not present within the household, as groceries, meals, snacks, and other forms of sustenance can vary drastically from week to week. This means that children often experience patterns of binge eating when food is available, and they may restrict their caloric intake—often out of pressure and necessity by parents to save money—when food is scarce. This leaves these children with an unpredictable cycle of eating that can manifest later as eating disorders. This fosters an extremely unhealthy relationship with food, and suggests mitigating food insecurity on a broad level would be a solution to this issue.  

Indeed, it is necessary to recognize that the problems that arise with eating disorders cannot be treated unless the root causes are examined. Much like many other health care issues, it is clearly evident that socioeconomic status and food insecurity contribute directly to eating disorder prevalence amongst poorer groups. In order to provide any semblance of a solution, treatment approaches must factor in these causes. Health care providers must examine these stressors when treating individuals and ensure that the medicine practiced accounts for socio-economic-related factors. Community-based programs and widespread system change would be necessary, especially on an educational level, in order to combat eating disorders amongst these populations. To inflict quantifiable change, eating disorders must be viewed as a public health disorder that certain groups are more vulnerable to. Solutions to eating disorders— just like their victims—cannot be monochromatic.