Latino/a/x and Body Image - National Eating Disorders Association

By Rocia Avila, LCSW

Latino/a/x like the general population are impacted by mental illness. Latino/a/x suffer from eating disorders, depression, anxiety, PTSD, and other mental health illnesses, however, they are not treated at the same rate nor do they seek treatment at the same rate. Talking about mental health in the Latino community can be rare and stigmatized which can be a barrier to seeking treatment.

Latino/a/x also face similar issues with regard to body image issues or distress. In general body image concerns have historically been connected to white women wanting to attain a thin body. In society and the media the concept of the thin ideal (or the desire to attain thinness) continues to be a focus and a skewed perception, that only thin, equals beauty. According to one large study in the United States, 45.5% of latinos and 56.1% of latinas experience body shape concerns.¹ Latinas experience the same societal pressure regarding western based beauty standards however Latinas often have to contend with other issues such as acculturation and acculturative stress, discrimination, grief if they have migrated from their country of origin, migration journey, lack of resources and support, all the while having to battle mental health and body image issues. One study indicated that Latino males also experienced body image issues specific to muscularity and wanting to attain more muscle mass and reported increased distress when comparing themselves to white or european males who genetically and biologically may have larger/muscular bodies.² The desire to attain a more muscular body can lead to eating disorders such as orthorexia including restrictive behaviors.

There are some Latino/a/x who migrated here or are children of immigrants who had to deal with a “migration journey” one in which likely involved disordered eating patterns (1 meal/day) perhaps dealt with food insecurity (limited food access) along with stress about how to obtain the next meal. These stressors sometimes continue for many years even after arrival and the trauma from the journey can lead to trauma responses. Disordered eating patterns can go hand in hand with esteem and body image issues which is likely to increase the risk of developing an eating disorder.

In summary Latino/a/x face a multitude of issues that lead to mental health issues and some specific issues that can lead to developing body image distress which can increase the risk for developing an eating disorder.

Barriers to Treatment

One study found that Latino/a/x subjects were less likely than their white counterparts to receive a recommendation or referral for evaluation when self-reporting eating disorder symptoms which researchers hypothesize is due to clinical bias of who does and does not have disordered eating.³ A more recent study has confirmed this, finding that hispanics were significantly less likely to seek help for an eating disorder, particularly anorexia nervosa than white subjects.⁴

Mental health is often not discussed in the Latino/a/x culture, oftentimes comments regarding bodies, size, height, general appearance, colorism are shared without regard to impact as it is often deep rooted in the culture to speak unfiltered about these topics. Oftentimes individuals are given nicknames as early as childhood, which they carry throughout their lifespan. For instance it is common to nickname someone “flaco” (skinny) and the individual may carry this nickname for their entire life, which plays a role in how the nickname is internalized, and where dissatisfaction can develop if someone’s body changes as they grow older and feel disconnected from their perceived identity/nickname and actual self. The many barriers along with cultural factors and a limited amount of resources available to the Latino/a/x community regarding body image issues make access to care more challenging. Latino/a/x being referred to care is less likely however when referred and when care is accessed finding individualized culturally attuned care is even more difficult to find.

Considerations for Treatment and Next Steps

It is important to address issues related to access for treatment regarding body image distress in the Latino/a/x population. Increasing resources both in English and Spanish is a first step. Stressing to providers that culturally attuned and informed, care in terms of culture and trauma are essential in reducing the gap to access. Additionally, further education and research regarding body image distress, disordered eating, and eating disorders in Latino/a/x is needed. Overall more information about the impacts of body image distress and eating disorders in the Latino/a/x population is an essential next step to begin addressing these issues in this group.

Sources

^[1]Olson, K. L., Lillis, J., Panza, E., Wing, R. R., Quinn, D. M., & Puhl, R. R. (2020). Body shape concerns across racial and ethnic groups among adults in the United States: More similarities than differences. Body image, 35, 108–113. https://doi.org/10.1016/j.bodyim.2020.08.013

^[2]White, E. K., Mooney, J., & Warren, C. S. (2019). Ethnicity, eating pathology, drive for muscularity, and muscle dysmorphia in college men: a descriptive study. Eating disorders, 27(2), 137–151. https://doi.org/10.1080/10640266.2019.1585717

^[3]Becker, A. E., Franko, D. L., Speck, A., & Herzog, D. B. (2003). Ethnicity and differential access to care for eating disorder symptoms. The International journal of eating disorders, 33(2), 205–212. https://doi.org/10.1002/eat.10129

^[4]Coffino, J. A., Udo, T., & Grilo, C. M. (2019). Rates of Help-Seeking in US Adults With Lifetime DSM-5 Eating Disorders: Prevalence Across Diagnoses and Differences by Sex and Ethnicity/Race. Mayo Clinic proceedings, 94(8), 1415–1426. https://doi.org/10.1016/j.mayocp.2019.02.030