Do africans get anorexia
Executive summary
Anorexia nervosa has been documented in African countries, but population-level epidemiological studies are few and give a mixed picture: several community surveys reported no DSM‑IV anorexia cases, yet clinical records and regional burden estimates show real and possibly rising numbers in parts of Africa and neighbouring MENA regions [1] [2] [3]. The literature stresses that limited data, changing diagnostic criteria, and atypical local presentations mean “rare” in surveys does not equal “absent” in reality [4] [5].
1. What the surveys actually found: low or zero prevalence in small community studies
Four formal epidemiological studies across parts of Africa that used DSM‑IV criteria reported no cases of anorexia nervosa among 1,476 young females in combined samples, and estimated point prevalences for bulimia nervosa and EDNOS rather than AN (bulimia ~0.87%, EDNOS ~4.45%), leading reviewers to conclude AN appeared very rare in those data sets [1] [6] [7].
2. Clinical records tell a different story: anorexia appears in treatment settings
Hospital and clinic-based series contradict the “no cases” narrative by documenting patients with classical AN: a 21‑year retrospective chart review at a South African tertiary hospital found anorexia nervosa accounted for about 26.5% of eating‑disorder diagnoses treated there, demonstrating that the condition does exist and can present to services in Africa [2].
3. Diagnostic change and atypical presentations complicate comparisons
Several authors warn that DSM revisions and cultural differences matter: some individuals in African studies who did not meet DSM‑IV AN criteria would meet DSM‑5 criteria, and local patients may present atypically—less emphasis on expressed weight concern or different body ideals—so community screens built around Western symptom clusters can undercount cases [1] [5] [8].
4. Regional burden estimates show increases, but rely on imputed data
Global and regional modelling studies report rising point prevalence and incidence of anorexia nervosa in the Middle East and North Africa between 1990 and 2019, suggesting geographic spread or detection changes; however, those models often rely on imputation where primary African data are missing, limiting certainty about true trends across the African continent [3] [4] [9].
5. Why survey absence is not proof of absence: methodological and cultural gaps
Researchers repeatedly highlight major research gaps—small, non‑national samples, reliance on self‑report screens, and omission of BED and other specified disorders from many datasets—which produce systematic blind spots; the Global Burden of Disease and subsequent analyses may therefore under‑ or mis‑estimate eating‑disorder burdens in African settings [4] [10].
6. Balance of evidence: anorexia occurs in Africa but population prevalence remains uncertain
The balanced reading is that anorexia nervosa does occur among Africans (documented in clinical case series and hospital audits), yet community epidemiological surveys to date have often failed to detect DSM‑IV AN cases and overall population prevalence estimates are weak because of limited, non‑representative data and diagnostic/phenomenological differences [2] [1] [11].
7. What this means for clinicians, policymakers and researchers
Practical implications are clear in the literature: there is a pressing need for larger, culturally sensitive epidemiological studies, improved clinical training to recognise atypical presentations, and inclusion of a broader range of eating‑disorder diagnoses in burden estimates so policy and services can match actual need [4] [11] [12].