New research from the University of Otago (Christchurch) suggests treatment methods should be specifically tailored and targeted because of the "multiple underlying causal factors".
Study co-author and Māori indigenous health innovation assistant research fellow Mau te Rangimarie Clark said the research was believed to be the first to investigate the perceived causal factors of eating disorders in Māori.
The study, which interviewed Māori aged 16 years or older with a lifetime diagnosis or self-identification of anorexia, bulimia or binge eating disorder, identified the need for an individualised treatment response to promote recovery.
The study built on Māori eating disorder research released last year, which identified clinician bias because of outdated stereotypes, idiosyncratic use of eating disorder assessment methods, and the location of treatment services as barriers to diagnoses and treatment for Māori, he said.
"This study digs deeper, looking at our study participants’ explanations of, firstly, what contributed to their eating disorder; secondly, their experiences of their treatment; and finally, what actually helped their recovery.
"Many participants pinpointed socio-cultural factors as causes for their eating disorders, such as Western body ideals of thinness, with one participant identifying the societal pressure she says she felt as a teenager for reinforcing the notion to her that whiteness and ‘pakeha looks’ were superior, leading to a heightened insecurity of her body image.
"Other eating disorder causes that our participants relayed were linked to adverse life events such as death, a relationship breakup, change of schooling, abuse and family dynamics.
"They impacted development and led to a sense of loneliness, insecurity and worthlessness, making them more vulnerable to the later development of an eating disorder."
Poverty was also identified as an eating disorder driver because limited access to food resulted in food-compensatory behaviours such as binge eating, Mr Clark said.
Study participants said it was difficult to get appropriate treatment in more generalised rural settings because Māori cultural support was reliant on the discretion of the healthcare practitioner treating them.
Many participants said seeking help also caused stress because private treatment was expensive, and having to take time off work to attend treatment sessions was a financial burden.
Having access to appropriate health information was reported as being vital for recovery, including learning about emotional self-regulation, improving inter-personal relationships and getting help with information about nutrition and exercise.
Earlier studies have already showed Māori were under-represented in eating disorder treatment settings, eating disorder rates among Māori were highest for those in social deprivation, and Māori were more likely to experience higher psychiatric co-morbidity and self-harm hospitalisation for eating disorders than non-Māori.
The study concluded that a strictly biomedical approach to treating eating disorders was not meeting the needs of Māori and their whānau.
