Ethnic differences in age of onset and prevalence of disordered eating attitudes and behaviours: a school-based South African study

Abstract

Objectives: To determine the age of onset and prevalence figures for disordered eating for diverse ethnic groups among a sample of South African schoolgirls. Method: A cross-sectional design was implemented. Two questionnaires were used to elicit prevalence figures and attitudes towards eating. Results: The study population (n = 418) consisted of black and white schoolgirls in various educational phases. Black students were found to experience a significant increase in reported bulimia-associated behaviours in grades seven to nine (mean age 13.7 years) but did not report any significant increases in drive for thinness, body dissatisfaction or poor eating attitudes across the different phases. White students reported significant increases in all measured disordered eating attitudes and behaviours in grades 10-12 (mean age 16.7 years). In grades four to six, black and white students did not differ with respect to their reported disordered eating attitudes and behaviours. However, in grades seven to nine, black students were more likely to report bulimia-associated behaviours than their white counterparts. The most apparent differences emerged in grades 10-12. White students reported significantly higher drive for thinness, greater body dissatisfaction and poorer eating attitudes than their black counterparts. Furthermore, the ethnic differences that emerged during grades seven to nine with respect to bulimia disappeared in grades 10–12. Conclusion: This study fills the hiatus in the existing South African literature with respect to age of onset and prevalence of disordered eating attitudes and behaviours across ethnic boundaries. Furthermore, it creates a foundation for developing appropriate strategies to address eating disorders in the multicultural South African context.

Keywords: disordered eating, onset, ethnic groups, EDI, EAT-26