Classification and correlates of eating disorders among Blacks: findings from the National Survey of American Life.

Objective: To assess classification adjustments and examine correlates of eating disorders among Blacks.

Methods: The National Survey of American Life (NSAL) was conducted from 2001-2003 and consisted of adults (n=5,191) and adolescents (n=1,170). The World Mental Health Composite International Diagnostic Interview (WMH-CIDI-World Health Organization 2004-modified) and DSM-IV-TR eating disorder criteria were used.

Results: Sixty-six percent of African American and 59% Caribbean Black adults were overweight or obese, while 30% and 29% of adolescents were overweight or obese. Although lifetime rates of anorexia nervosa and bulimia nervosa were low, binge eating disorder was high for both ethnic groups among adults and adolescents. Eliminating certain classification criteria resulted in higher rates of eating disorders for all groups.

Conclusion: Culturally sensitive criteria should be incorporated into future versions of Diagnostic Statistical Manual (DSM) classifications for eating disorders that consider within-group ethnic variations.