Study finds social inequality shapes eating disorder diagnoses

Kringvarp Føroya (KVF) reports that children from affluent families are diagnosed with eating disorders significantly more often, while young people from less-resourced homes face more than twice the risk of having serious symptoms without ever receiving help.

The findings challenge the longstanding perception that eating disorders primarily affect teenage girls from affluent families. A new PhD study from the University of Copenhagen suggests that this image is largely shaped by a healthcare system that does not identify everyone equally.

Led by Faroese researcher Andrea Joensen, the study used public health data on more than 500,000 Danes and a survey of 44,000 young people in the Better Health in Generations birth cohort.

Among young people who had received an official diagnosis, those whose parents had longer higher education had a 35 percent greater risk of being diagnosed. However, when researchers asked young people about their actual symptoms, those whose parents had only primary education were more than twice as likely to report serious symptoms of anorexia, bulimia or compulsive eating.

Joensen said the findings showed a major social difference in who is identified. An official diagnosis requires that a problem is noticed and that the person is referred for further care, meaning diagnoses do not provide a true picture of who is ill.

The study indicates that parents with higher education may be better able to navigate the healthcare system, explain problems to doctors and demand appropriate treatment. Their children are therefore more likely to enter the system, while young people from less-resourced homes may be overlooked.

Eating disorders often begin early in adolescence, frequently between the ages of 12 and 15. The longer a person goes without help, the more deeply the illness can become established. Joensen said eating disorders are serious mental illnesses that can become chronic and, in the worst cases, life-threatening.

She also said professionals need a broader understanding of what eating disorders look like. They affect not only extremely thin girls with anorexia, but also men and people of normal weight or who are overweight and struggle with compulsive eating.

Joensen has continued at the University of Copenhagen in a postdoctoral position, where she and researchers in England and Norway will examine whether the same social inequality exists there.