The prevalence of eating disorder pathology in a cross-ethnic population of female students in South Africa

Objective: The purpose of this study was to determine the prevalence of eating disorder pathology in female students representing South Africa's ethnically diverse population. A secondary aim was to explore relationships between eating disorder pathology, Body Mass Index (BMI), and socioeconomic status (SES). Method: In a questionnaire survey of a cross-section of South African college students, the Eating Disorder Inventory (EDI) was administered to a convenience sample of 628 students (52 per cent white, 38.6 per cent black, and 9.4 per cent Asian, persons from Indian descent). EDI subscale scores were calculated and compared by ethnicity. BMI scores were related to EDI subscale scores and to categorizations of respondents' SES status and rural versus urban origins. Results: White women showed the highest EDI body dissatisfaction (p < 0.01), while blacks the highest drive for thinness and perfectionism (p < 0.01). Asians scored highest on interpersonal distrust (p < 0.01). There were marked differences between ethnic groups with regard to BMI, eating pathology and SES. High BMI was associated with urbanization and low SES. Rising SES was associated with lower BMI scores. Blacks had higher BMI scores than whites and Asians. Discussion: The results show significant eating disorder pathology in South African women across ethnic diversity. Our findings challenge the assumption that eating disorder pathology is confined to Western societies and raise the possibility that the risk for eating disorders in developing countries may be increasing. Copyright (C) 2000 John Wiley and Sons, Ltd and Eating Disorders Association.