Behind Closed Doors: Latino Binge Eating

Margarita Alegria, director of the center for multicultural mental health research at the Cambridge Health Alliance, discusses binge eating and why Latinos may be particularly vulnerable to the disorder.

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CHERYL CORLEY, host:

I'm Cheryl Corley. This is TELL ME MORE from NPR News. Michel Martin is away.

Coming up: Baltimore Mayor Sheila Dixon tells us what's playing in her ear.

But first, it's time for our regular feature Behind Closed Doors, where we talk about tough issues that often aren't so easy to discuss. Today, we're talking about binge eating. There are some new research that indicates Latinos may be especially prone to the eating disorder, and we wanted to know why.

Margarita Alegria led the study. She's the director of the Center For Multicultural Mental Health Research at the Cambridge Health Alliance, also a professor of professor of psychiatry at Harvard Medical School. And she joins us on the line from Maine. Welcome.

Professor MARGARITA ALEGRIA (Psychiatry, Harvard Medical School; Director, Center For Multicultural Mental Health Research, Cambridge Health Alliance): Hello.

CORLEY: Well, you know, I think we're all familiar with the concept of binge drinking. And so I wanted to know how you define binge eating. Is it essentially the same, except we're talking about food?

Prof. ALEGRIA: Well, actually, binge eating, it's really frequently consuming large amounts of food, you know, while feeling like a lack of control over eating. It's very related to having a large amount of food that's greater than normal in a very short period of time, you know? And people typically feel like they cannot stop eating. So it's very similar, in that sense, to binge drinking.

CORLEY: So you're not really sure or certain when you're full?

Prof. ALEGRIA: Well, actually, you keep on eating even though you know that you're full. That's part of the feeling, of feeling uncomfortably full. And people typically eat much more rapidly than normal and are actually typically eating alone because they're embarrassed about how much they're eating.

CORLEY: Well, how did you go about the research? As you mentioned, binge eating isn't something people just openly talk about.

Prof. ALEGRIA: Well, actually, this is a part of a bigger study, where we're very interested in trying to learn more about the patterns of psychiatric illness in Latinos. And we were very interested in trying to see binge eating as a possibility, because it's something that's new. People are starting to not only look at anorexia and bulimia, which are typically the eating disorders, but more about binge eating because it might signal early detection of the need for more screening of a person that's actually not coping well with their eating habits.

CORLEY: Mm-hmm. Well, this is the first study of its size and scope. I have to mention the results are not definitive. But tell me about the key findings.

Prof. ALEGRIA: Well, I think some of those key findings, first, is that we have like around five of every 100 people are really showing signs of any binge eating, so - in their lifetime. And it's around three out of every hundred people that show any binge eating at least in the last 12 months. I think some of our main findings is that anorexia and bulimia are actually very low. People do not show this as to be a big issue in terms of eating disorders, but it's very serious for those that do have it. However, what we're finding is that a (unintelligible) 12 months prevalence of binge eating is actually high, and that we find that it's more typical in people that have been in the U.S. for longer time periods than those that are recent immigrants, which is sort of an important finding.

CORLEY: Mm-hmm. Do you know why?

Prof. ALEGRIA: Well, we think it has to do a lot with the - this concept of slimness, that people are very molded into trying to look very slim and trying to comply with the standards of weight of the U.S. population. And the more you're here, the more exposed you are to those standards. I think there's a lot of speaking about being slim and having people looking better if they're actually lower weight. And I think that leads people then to start integrating this concept about looking slim.

CORLEY: This is TELL ME MORE from NPR News.

If you just joined us, I'm talking with Margarita Alegria about her study of binge eating in the Latino community. You surveyed both Latino women and Latino men. Were there any differences?

Prof. ALEGRIA: Actually, we didn't find any difference for binge eating. But that's actually been found also for the general population. We did see a trend for anorexia and bulimia, but it actually was not statistically significant. So we didn't find those differences that are typically seen.

CORLEY: Mm-hmm. Well, talk to me about some of the reasons why Latinos might be turning to binge eating.

Prof. ALEGRIA: I think binge eating is a really a way - might be very related to several things. I think one is this concept of trying to really cope with stress and the issue about the possibility that they're, you know, having very difficult times of having normal patterns of eating because of work schedules and because of how people sort of try to cope with weight.

One of the worst that we found in our study was that people that are obese, or very obese, actually have much higher rates of binge eating. So it might be a way of trying to cope, you know, with weight gain in a very - in a way that's not really adequate.

CORLEY: You're saying the study that a typical Latino lifestyle could explain some of the disparity as well. What did you mean by that?

Prof. ALEGRIA: Well, I mean, I think that one of the - the disparity was more in terms that people are not seeking care, and that's one of the worries that we found in this study, that so few people are actually getting any sort of treatment and being recognized or detected. So it means that a lot of people are going actually untreated for something that can be - have a very serious consequence.

CORLEY: And why are people less likely to want to talk about eating disorders?

Prof. ALEGRIA: I think they are less likely to talk about eating disorders, first, because they are ashamed about it. I think there's a lack of people's awareness that this is a disorder that people should be talking to their primary care providers about it and explaining that they're having problems trying to cope with their weight gain, trying to get for other adequate solutions. And I think there's not a lot of information to tell people about what are the signs and symptoms of binge eating.

CORLEY: And what are you hoping your research will do? Sort of turn that around?

Prof. ALEGRIA: Exactly. That both providers, healthcare providers, become more aware that this is something that they should be assessing, especially if people are obese or overweight. That they should give more information to people about how to handle their weight concerns in an adequate way. And for people to start recognizing that there's help out there to get them, you know, more advice and more support for eating disorders.

CORLEY: Margarita Alegria is director of the Center for Multicultural Mental Health Research at the Cambridge Health Alliance and a professor of psychiatry at Harvard Medical School. Thank you so much for joining us.

Prof. ALEGRIA: Thank you.

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