Prevalence of eating disorders and disordered eating in First Nations Peoples in high-income, colonial settler countries: a scoping review

Disordered eating (DE) is often a feature of the eating disorder (ED) prodrome. EDs are complex mental health conditions which affect approximately 4% of Australians. However, research on DE and EDs in Aboriginal and Torres Strait Islander Australians is scarce, with fewer than ten peer-reviewed studies available. These studies suggest Indigenous Australians may experience DE and EDs at equal or higher rates than non-Indigenous Australians. This scoping review aimed to map the literature on the prevalence and presentation of eating disturbances in populations comparable to Indigenous Australians-that is, First Nations Peoples from high-income, colonial settler countries-in order to identify translatable knowledge gaps and research priorities. Following Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a systematic literature search of seven databases, data extraction, and narrative synthesis were conducted. Publications in English reporting the prevalence or presentation of DE or EDs among First Nations Peoples in Australia, New Zealand, the United States, Canada, and Scandinavian countries were eligible. Sixty-four publications met eligibility criteria. Lifetime ED prevalence in First Nations adults ranged from 3.3% to 4.3% for females and 0.4% to 2.6% for males. For children/adolescents, prevalence ranged from 10% to 15.6% for females and 4.4% to 5.3% for males. Body mass index, age, self-concept, psychosocial stressors, substance use, and social connection were linked to eating disturbances. Colonisation and racism affect ED experiences and treatment-seeking. Future research must include culturally validated models and tools, with leadership and co-design by Aboriginal and Torres Strait Islander communities.