Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review

Why is this research important? 

This paper highlights the need for further research into eating disorders among Aboriginal and Torres Strait Islander peoples, and specifically the need for development of culturally appropriate screening or diagnostic tools. This research is needed because we know that Aboriginal and Torres Strait Islander peoples experience poorer mental health and psychosocial wellbeing and higher psychological distress than non-Indigenous Australians. We also know that eating disorders often have onset in youth, and that the Aboriginal and Torres Strait Islander population is younger than the wider Australian population.

Prior to this paper, no review studies had been undertaken on eating disorders among Aboriginal and Torres Strait Islander people. This paper reports on the findings of a scoping review to understand the volume and content of the existing literature as well as to determine whether any culturally appropriate screening or assessment tools for eating disorders had been developed. The review strongly suggests greater eating disorder prevalence among Aboriginal and Torres Strait Islander peoples than non-Indigenous Australians, but found no studies addressing screening or diagnosis for this population.

The authors call for greater eating disorder awareness among the Indigenous health workforce, school teachers, and parents. They also highlight the need for further research into identification, uptake of treatment and effective treatments for Aboriginal and Torres Strait Islander people and argue that a culturally validated screening tool ought to be a research priority. Indigenous research methods should also be used to build understanding of the nature of eating disorders among this population and develop effective treatments.

Authors: Adam Burt, Deborah Mitchison, Kerrie Doyle, Phillipa Hay

Abstract/Summary: 

Background: Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have poorer mental health compared to other Australians. Yet, there is a lack of research into mental disorders among this population, especially for eating disorders (ED), which are amongst the most lethal and debilitating mental disorders.

Aim: We aimed to answer two questions: 1. What is the volume and content of literature on ED among Indigenous Australians? 2. Has a screening or diagnostic tool/instrument been developed for the assessment of ED amongst Indigenous Australians?

Method: We conducted a scoping review of electronic databases (Pubmeb, Embase, PsychInfo, Proquest, Cochrane Library, Indigenous HealtInfoNet and Scopus), for studies addressing ED, body image, muscle dysmorphia, weight and shape concern among Indigenous Australians, as well as diagnostic and screening tools. All relevant studies were reviewed in full by two researchers. Narrative synthesis of the data was performed.

Results: There is limited evidence for ED among Indigenous Australians, however, the evidence available strongly suggests that ED are more common among Indigenous Australians compared to other Australians. Eating disorders among Indigenous Australians are also associated with high levels of overvaluation of weight and shape. The increased risk of ED among Indigenous Australians was largely explained by factors such as poorer psychosocial wellbeing. No evidence was found for the existence of validated diagnostic or screening tools for ED in Indigenous Australians.

Conclusion: The evidence suggests ED are common among Indigenous Australians, and there are no diagnostic or screening tools available to assist clinicians in assessing them. More research is required in this field, especially towards the development of a validated and culturally specific screening or diagnostic tool for ED among Indigenous Australians.

Access: Open

Link: https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-020-00346-9

Citation: Burt, A., Mitchison, D., Doyle, K. et al (2020). Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review. J Eat Disord 8 (73).