Aboriginal and Torres Strait Islander peoples are well known to have higher risk for a range of disorders related to poor nutrition, namely a diet high in refined carbohydrates and saturated fats. This leads to subsequent increased risk for obesity, Type 2 diabetes, cardiovascular disease and renal disease [1
]. In addition there are higher rates of admissions for mental health problems and self-harm in indigenous Australians [1
]. Research into mental health problems closely related to nutrition and obesity such as disordered eating and binge eating is minimal within Australia. However, international research indicates that these problems are prevalent in other indigenous cultures. A recent review of eating disorders in North American indigenous peoples found disordered eating and weight control behaviours, body dissatisfaction and eating disorders (where measured) were as frequent in First Nations or Inuit peoples as in White or other Americans [2
]. One of the eight studies reviewed was a national US study of young adult women that in particular reported a higher frequency of indigenous women having problems with uncontrolled and/or 'embarrassing overeating' compared to non-indigenous [3
]. The studies in this review were however confined to adolescent samples or College recruited samples [2
]. Of concern, indigenous people were less likely to be referred on for further evaluation of their eating problems.
Further controlled [4
] and uncontrolled [5
] studies in Canada and the US have found high body dissatisfaction (desire to be thinner) and increased risk for an eating disorder in indigenous peoples, particularly youth. A recent large (10,334 participants, mean age 21.93 years) national US survey [7
] of adult men and women has found higher rates of current binge eating, embarrassment about excessive eating, loss of control over eating, higher weight, but not a self-reported diagnosis of an eating disorder or use of inappropriate weight control behaviours in American Indian or Native American men (n = 236) and women (n = 253).
In Australia studies of indigenous peoples are confined to adolescent samples and have been focussed on body image disturbance. An Australian report found higher levels of body dissatisfaction and a desire to build up muscle in indigenous males but lower or similar levels of body dissatisfaction in female indigenous adolescents compared to non-indigenous. Both indigenous groups had greater engagement with weight control practices [8
] but indigenous females appeared less influenced by socio-cultural pressures to reduce weight [9
]. The same group [10
] found similarly greater body dissatisfaction in urban and rural non-indigenous adolescents but this study did not report on use of weight loss behaviours. In a national study of health, eating, weight and culture among 7889 school children in every Australian state and territory, 333 were of indigenous origin. In this study indigenous females and males perceived themselves as heavier in body weight but were more likely to be trying to gain weight and build up their bodies and to be advised by parents and family to do so [11
]. These mixed reports may indicate different attitudes towards body shape, and a greater desirability for muscular strength in indigenous compared to non-indigenous Australian adolescents. However, there is no information on how, if at all, these differing attitudes indicate a problem with eating disorders and weight in older adolescents and adults.
Our aims were therefore to investigate the current 3-month prevalence of eating disorder behaviours of binge eating, restrictive dieting, and extreme weight control methods such as vomiting, and core eating disorder psychopathology of excessive weight and shape concerns, in a representative general population sample of older adolescent and adult indigenous Australians.