Racial and ethnic considerations in the United States

Men are underrepresented in the eating disorder literature, but there is an even greater underrepresentation of racial and ethnic minority men in empirical work on etiology, assessment, and treatment of eating disorders. This review summarizes the existing literature on eating disorder symptoms and behaviors in Black, Asian American, Latino, and Native American men within the United States, including acculturation and discrimination as salient culture-specific variables. The impact of implicit biases on the type and focus of studies within the existing literature is described. In reviewing the prevalence of eating disorder behaviors, Black men engage in more weight control, muscle building, and binge eating than White men. Comparisons between Asian American and White men on eating disorder behaviors are inconsistent. Latinos, Native Americans and other First Nations men engage in more weight control behaviors and binge eating than White men. Thus, with the exception of Asian American men, eating disorder behaviors appear to be more prevalent among racial and ethnic minority men. Acculturation, or internalization of Western values and ideals, is associated with eating pathology in Black men, and the stress of acculturating is associated with eating pathology in Latinos. Yet among Native American and other First Nations men, acculturation is associated with less eating pathology. Among Black men, discrimination is associated with emotional eating. There is a dire need for research on the suitability of eating disorder assessments for racial and ethnic minority men. Further, there is a need for efficacy and effectiveness studies examining contemporary interventions in the prevention and treatment of eating disorders in these understudied populations.