Eating Disorders in Africa

There is a dearth of research regarding eating disorders (EDs) in Africa. The first reports of EDs in Africa emerged in the 1970s and 1980s. Recent systematic reviews on the prevalence of EDs did not include any studies from Africa. The few studies undertaken suggest that the prevalence of anorexia nervosa (AN) and bulimia nervosa (BN) is lower in Africa than globally, and that women with AN-related pathology may present atypically, with less weight concern. Although few studies have evaluated binge-eating disorder (BED) in Africa, studies in other settings have found higher rates in black individuals compared to other ethnicities, emphasizing that BED should be further investigated in Africa. Furthermore, in certain African settings BED may be linked to a larger body size ideal suggesting the pathways leading to BED may be different in some African settings. Pica may be challenging to diagnose in Africa, due to common practices, such a geophagy, and more work is needed to disentangle pica from cultural practices. High rates of ED-related pathology have been reported in Africa, although evidence is largely from self-report instruments. Factors associated with ED pathology in Africa include female sex, ethnicity, socio-economic status, body mass index (BMI), Western media exposure, acculturation, urbanization, and trauma. Furthermore, studies suggest EDs may present atypically in some African settings and that the pathways to EDs may also be somewhat different, such as through cultural and religious rituals. Similar to other settings, high comorbidity is demonstrated with other psychiatric disorders, and EDs contribute to significant disability. There is a clear need for more research regarding EDs in Africa, particularly larger epidemiological studies, and qualitative research to understand how EDs may present differently in African settings.