This blog looks at the key takeaways from a report that was produced as a part of the King’s Undergraduate Research Fellowship 2022 at the Social, Genetic and Developmental Psychiatry Centre in Denmark Hill, London.
Mohini, undergraduate research fellowship student
Bulimia nervosa and binge-eating disorder are binge-type eating disorders, which means they involve recurring episodes of binge eating. This is where a person experiences a lack of control over what and how much they are eating, leading them to eat more than what most individuals would under the same circumstances. Research into these disorders (their development, diagnosis and treatment) is incredibly important as these binge-type eating disorders account for 41% of all individuals who have experienced an eating disorder in their life. Additionally, eating disorders can cause physical, psychological, and emotional damage, and have a higher financial burden than that of anxiety and depression. Historically, there has been minimal research into eating disorders within minoritised ethnic communities. Recently, however, there have been advances in our understanding; we need to continue making these advances to improve the experiences of individuals from these backgrounds.
The project
This project aimed to look at whether being of a minoritised ethnic background in the UK, and therefore not having a culturally-mainstream experience of healthcare services, is associated with whether an individual is clinically diagnosed with a binge-type eating disorder. There was also a focus on the correct use of terminology in scientific research, steering away from the use of “BAME/BME” or “Ethnic minorities”. Instead, we used the term “Minoritised Ethnicities.” This term highlights that minoritised ethnic communities have been belittled as a result of the social domination of another ethnic group within the UK, and shows that the ethnicities covered in this umbrella term do not all have a singular cultural experience of healthcare services.
We used data from participants of three, large UK-based mental health studies (the GLAD Study, EDGI UK* and the COPING Study) who were asked about any eating disorder symptoms they may have experienced in their life, as well as any psychiatric disorder diagnoses they had ever received from a healthcare professional. We also looked at data on the ethnic origin of the participants.
Our findings
We started by looking at the numbers of people who a) met the clinical criteria for at least one binge-type eating disorder as identified in our questionnaire and b) reported that they had been diagnosed by a healthcare professional. To produce the rates of diagnosis, the number of participants who had both a self-reported clinical diagnosis and a symptom-based questionnaire diagnosis was divided by the total number of participants with at least a symptom-based questionnaire diagnosis.
We then looked at this proportion across two different ranges of ethnic groups (a ‘broad’ range, and a more ‘in-depth’ range): the ‘broad’ range consisted of the “White”, “Minoritised Ethnicities” and “Other” samples, and the ‘in-depth’ range further splits apart the individual ethnic groups that make up “Minoritised Ethnicities” (“Mixed”, “Asian or Asian British”, “Black or Black British” and “Arab”).
Both the “White” and “Minoritised Ethnicities” samples were similar with regards to their sex and levels of education. However, the “White” sample was, on average, slightly older than their “Minoritised Ethnicities” counterparts.
We found no significant difference in rates of clinical diagnosis between the “White” (23.67%) and “Minoritised Ethnic” (20.65%) samples (Figure 1), or between comparisons of each more in-depth ethnic categories from the secondary analysis. However, it is not known whether this is a truly non-significant finding as the “Minoritised Ethnic” sample size is very small (n = 276) and therefore likely does not accurately reflect the UK population. It is also much smaller than the “White” sample (n = 6,281).
Key summary points & reflection
The results of this project highlighted that there is an overall low rate of clinical diagnosis for binge-type eating disorders (~20%) in those who met the criteria for a binge-type eating disorder via the symptom-based questionnaire. This low rate needs to be addressed, particularly when comparing it to the number of participants who have met clinical criteria for a binge-type eating disorder. Moreover, our results stress the importance of increasing engagement of “Minoritised Ethnic” participants in eating disorder research, as the “White” sample had 6,281 participants, whilst the “Asian and Asian British” sample had 58 participants, and the “Black and Black British” sample had only 26 participants. This can be achieved by increasing funding in the hugely underfunded area that is eating disorder research (particularly in comparison to other mental illness research). From this, engagement campaigns can be created, which could help overcome the current under-representation in eating disorder research.
Acknowledgements
Special thanks to the SGDP Centre Anti-Racism Working Group for supervising and supporting this project.
