Eating disorders leave many people in Latin America cycling between feast and famine at the dinner table. In one Brazilian group of patients with bulimia, daily energy intake ranged from just 158 calories to more than 19,000 calories. Those extremes matter because they often coincide with shortfalls in iron, magnesium, folic acid and vitamin E, nutrients the body cannot store in large amounts.
A team of nutritionists and psychologists from Peru and Costa Rica set out to map what people diagnosed with eating disorders actually consume across the region. Their scoping review appeared in the Journal of Eating Disorders after a search of Medline, the Cochrane Library and LILACS up to November 2025. Only four studies met the criteria of a formal clinical diagnosis and a detailed record of food intake. All four were carried out in Brazil, two of them in Rio de Janeiro and one in Sao Paulo.
None of the participants had anorexia nervosa. Most were adults in early or middle adulthood living with binge eating disorder, bulimia nervosa or recurrent binge eating that fell short of a full diagnosis. During recorded binge episodes the highest average intake occurred in the binge eating disorder group, at 1,184 calories, although the differences between diagnostic groups did not reach statistical significance. Carbohydrates typically supplied around half of the energy, with fats next and protein last.
Everyday Brazilian staples appeared again and again. Rice and beans were eaten more often by people with binge eating disorder than by those with bulimia. Beef, biscuits, cakes, desserts and chocolate also featured prominently, especially in meals that later ended in self induced vomiting. Highly palatable foods supplied most of the calories in many binge episodes, and sugary drinks were common among patients with bulimia.
Researchers used 14 day food diaries, 24 hour recalls and targeted questions about recent binge episodes. Interdisciplinary teams of dietitians and mental health clinicians collected the data, a combination the reviewers regard as a practical strength. Even so, the authors argue that instruments designed in North America and Europe still require cultural adaptation before they can be trusted in Latin American kitchens.
The geographic narrowness of the evidence is itself a finding. Latin America and the Caribbean contain dozens of distinct food cultures, yet almost every detailed dietary snapshot comes from two large Brazilian cities. Children and people with anorexia remain invisible in the published record. Earlier prevalence work already shows that binge eating and bulimia occur at appreciable rates in upper middle income settings such as Brazil, so the absence of comparable dietary data from poorer or more rural countries is striking.
Clinicians who understand that patients may binge on rice, beans and sweets rather than on pizza or ice cream can give more relevant advice. Regular meals and targeted micronutrient support still matter, whatever the local plate looks like. The reviewers therefore call for new studies that reach beyond Brazil and for assessment tools that respect the foods people in the region actually eat.
