Diversity and Eating Disorders: Changing the Face of the Diagnosis

Contributor: Marissa Edwards, Ph.D., at The Center for Eating Disorders at Sheppard Pratt

Picture someone with an eating disorder. The image that probably popped into your head was a white, straight, thin, young woman, right? This is the description that has traditionally been thought to depict eating disorders, making many think that others who look different are somehow exempt. This example shows the importance of understanding diversity in the realm of eating disorders.

Countless reasons, including societal and cultural influences, perpetuate these stereotypes surrounding eating disorders. But, this belief that only a certain type of person can suffer from an eating disorder is a dangerous misconception.

The truth is that eating disorders do not discriminate. Eating disorders can affect people of all racial and ethnic backgrounds, sexual orientations, body types, and gender identities. Given the widespread impact of eating disorder representation, we must take a close look at the absence of diversity in eating disorder spaces, and work to change the face of eating disorders.

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BIPOC Populations

Despite mainstream misconceptions, eating disorders affect people from all demographics and ethnicities at similar rates. However, those who identify as BIPOC (Black, Indigenous, or Person of Color) are shown to receive treatment at alarmingly low rates.

Research has shown that those who identify as BIPOC are significantly less likely than white people to have been asked by a doctor about eating disorder symptoms and are only half as likely to be diagnosed or receive treatment for an eating disorder [1,2]. This not only makes access to treatment more difficult but may also make the decision to seek treatment uncomfortable.

Despite similarities in symptoms, BIPOC individuals are commonly underrepresented in eating disorder treatment, which may incorrectly accentuate a lack of need for treatment among the population. However, lack of access to care, systematic racism, and widespread stereotypes regarding eating disorders are more likely to contribute to the gap in care.

LGBTQIA+ Populations

Woman struggling with doctors who don't understand diversity and eating disordersIndividuals who identify as LGBTQIA+ often experience unique challenges that contribute to the development of an eating disorder. LGBTQIA+ individuals face increased potential factors that may play a role in developing an eating disorder, including negative messages about gender identity, inability to meet perceived body image ideals, bullying, and discrimination.

Gender dysphoria and body dissatisfaction in the transgender population are often cited as key contributors to eating disorders. Non-binary people may restrict their eating to appear thin, consistent with the common stereotype of androgynous people in popular culture. While research has more recently examined the relationship between gender identity, sexuality, and eating disorders, continuing research is needed to fully understand the connection.

Body Type Diversity in Eating Disorders

Eating disorders are primarily thought to occur in individuals who are underweight and extremely thin. However, eating disorders can affect all kinds of bodies – you cannot tell by looking at someone if they have an eating disorder.

While the measure of weight itself is not a determining factor for an eating disorder, many individuals may become hesitant to acknowledge they are suffering from an eating disorder due to not feeling “sick enough” if they are not thin or underweight. False assumptions about the “look” of an individual with an eating disorder can be a damaging factor that prevents many individuals from seeking treatment.

Men

Man struggling with diversity and eating disordersDue to rampant stigma, men suffering from eating disorders and body image issues have been neglected in both diagnosis and treatment. According to the National Eating Disorder Association (NEDA), in the United States alone, eating disorders will affect 10 million males at some point in their lives.

Nearly one in three people struggling with an eating disorder is male. Disordered eating behaviors (including binge eating, purging, laxative abuse, and fasting for weight loss) are nearly as common among men as they are among women. Several factors lead to men and boys being under- and undiagnosed for an eating disorder.

One major factor is due, in large part, to societal and cultural bias. This decreases the likelihood that men will seek treatment. Additionally, assessment tests with language geared to women and girls have led to misconceptions about the nature of disordered eating in men.

Impact of Diversity in Eating Disorders

When it comes to understanding eating disorders, it is imperative to recognize that anybody can be impacted, regardless of gender, race, identity, or appearance. We all need to work to challenge the stigmas and inaccurate stereotypes that have been assumed to be true for far too long.

By increasing awareness about the diversity of those impacted by eating disorders, we can encourage someone who may be struggling to get the life-saving help they deserve. Recovery, like the nature of eating disorders, is not uniform, and no one is excluded from getting the help they need. In recent years, researchers and treatment organizations alike have adapted to increase inclusivity in eating disorder care.

Developments are being made regarding how treatment can affirming and welcoming without exception. Many eating disorder treatment centers utilize individualized treatment plans to account for the diverse nature of their patient populations. By ensuring the needs of the individual, improvements in recovery are being made. The good news is, recovery is possible no matter the background or identity of an individual.


Resources:

[1.] Economics, D. A. (2020). The social and economic cost of eating disorders in the United States of America: a report for the strategic training initiative for the prevention of eating disorders and the academy for eating disorders

[2.] People of Color and Eating Disorders. (2018). Retrieved from https://www.nationaleatingdisorders.org/people-color-and-eating-disorders


About the Author:

Marissa Edwards Headshot

Marissa Edwards, Ph.D. is a post-doctoral fellow at The Center for Eating Disorders at Sheppard Pratt. In her role, she provides individual and group therapy to patients of all ages, specializing in the young adult population. Dr. Edwards has worked with individuals with various mental illnesses, health, behavior, and emotional difficulties and is passionate about improving the lives of her patients through evidence-based treatment.

Her professional interests include increasing the utilization of mental and physical health treatment among minority populations, providing training and education regarding mental health, and working with millennial clients to improve life satisfaction


Sheppard Pratt LogoThe Center for Eating Disorders at Sheppard Pratt provides treatment for adults and adolescents with complex eating disorders. We call eating disorders “complex” because each disorder has its own unique set of causes, symptoms, and health risks, and every individual may experience the illness and the recovery process differently.

Everything we do is guided by our extensive experience and the latest research into the biological, psychological, and social factors of anorexia nervosa, bulimia nervosa, and binge eating disorder.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published December 11, 2020, on EatingDisorderHope.com
Reviewed & Approved on December 11, 2020, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.