The dismantling of a myth: a review of eating disorders and socioeconomic status.
OBJECTIVE
A key feature of the stereotype that exists of those groups and individuals most likely to develop an eating disorder relates to socioeconomic status. The prevailing wisdom about this relationship is that there is an increased prevalence of eating disorders in high socioeconomic groups. The aim of this paper is to assess the validity of this view and to examine the ways in which this stereotype was created.


METHODS
Articles written between the early 1970s and the early 1990s, which include assessment of socioeconomic status, are reviewed and the evidence for and against the stereotype is examined.


RESULTS
It was found that existing research fails to support this stereotype for eating disorders as a whole, that the relationship between anorexia nervosa and high socioeconomic status remains to be proved, and that there is increasing evidence to suggest that the opposite relationship may apply to bulimia nervosa.


CONCLUSIONS
The powerful influence of clinical impression, sources of bias in referral procedures, methodological problems in existing research, and the failure to adequately separate anorexia nervosa from bulimia nervosa when referring to common predisposing factors, are discussed in relation to why the stereotype exists.
Gard
M C
MC
Royal Edinburgh Hospital, Scotland.
Freeman
C P
CP
D000856:Anorexia Nervosa / Q000453:epidemiology; D015982:Bias; D002032:Bulimia / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D013240:Stereotyping