Research highlights the need for culturally specific screening tools

Despite research finding a higher prevalence of eating disorders among Aboriginal youth in Australia, new research from Edith Cowan University (ECU) has revealed a lack of culturally specific and validated screening tools or early response programmes to address this issue.

Recent research suggests that 28.6 per cent of Aboriginal youth were affected by eating disorders, compared with some 21.7 per cent of non-Aboriginal Australian youths, with nighttime binge eating being the most common occurrence.

Lead researcher and accredited practicing dietitian Dr Kanita Kunaratnam noted that eating disorders were associated with psychosocial components, such as racism, trauma and food insecurity, citing experience from her own clinical work.

“Binge eating tends to be the most common eating disorder among Indigenous Australian youth, because many have grown up in food insecure households. While their financial circumstances may change, untreated eating disorders often persist into adulthood, particularly when underlying factors like trauma and food insecurity are not addressed.

There are also high levels of body image concern, historical intergenerational trauma and the ongoing psychological impact of socioeconomic disadvantage, which further exacerbates mental health conditions in this group.

“Eating Disorders in general are not well understood within Aboriginal and Torres Strait Islander communities. There is often a perception that people living in larger bodies are judged as overeating, without understanding that an eating disorder or other health issues might be underlying,” Dr Kunaratnam said.

While it is understood that cultural and societal factors have a significant influence on the presentation and management of eating disorders, which necessitates culturally specific approaches to screening and prevention, the ECU research showed there were no screening tools or early response programmes that have been specifically developed for, and in conjunction with, Aboriginal and Torres Strait Islander people in Australia.

“Importantly, we believe the current prevalence is likely underestimated. Without culturally specific approaches to screening, many young people may be missed entirely in both clinical and community settings,” Dr Kunaratnam said.

This lack of screening tools and response programmes could also mean that eating disorders are potentially missed by clinicians treating Aboriginal and Torres Strait Islander young people, as eating disorders among this community present differently to Western or white populations.

Dr Kunaratnam noted that the cultural context in which screening tools and early response programmes are administered, are of critical importance to their success, adding that prevention progams would not be successful if they were simply tokenistic.

“These tools have to be built from the ground up. It must include Aboriginal and Torres Strait Islander stories, their voices and their lived experience, to ensure these programmes are effective and sustainable long term.”

Dr Kunaratnam will be piloting the development of a culturally specific screening tool for First Nations peoples, with Dr Seraina Agramunt, Associate Professors Natalie Strobel and Jocelyn Jones from Kurongkurl Katitjin.