Eating disorders in Southern Africa: an update on prevalence, recognition, and clinical implications.

Abstract

Recent publications call for research on eating disorders in Southern Africa. However, research is scarce, dated and heavily relies on unvalidated self-reports conducted mainly among young, urban women. This narrative review deliberate challenges in recognizing and identifying eating disorder pathology in Southern African populations and discusses research and clinical implications. The prevalence in Southern Africa is 0.7%, and 0.5-4.7% for the named eating disorders. Cultural, linguistic, and dietary practices may obscure recognition of eating disorder pathology. Evidence on body image concerns is mixed, suggesting that these differ from Western contexts. Interactions between ethnicity and broader socio-cultural factors remain underexplored. These gaps highlight the need for contextually relevant research and for co-developing interventions with local researchers, clinicians, and individuals with lived experience. The comprehension of eating disorder pathology in Southern African populations remains limited. Understanding and including linguistic, socio-cultural and socio-economic factors is essential. Qualitative research offers an important starting point to explore body image, disordered eating thoughts and behaviors, and underlying mechanisms in these populations.