Within the eating disorder treatment community, we often state that, “eating disorders do not discriminate.” This is true in so far as eating disorders impact people of all races, genders, ages, sizes and socioeconomic backgrounds. However, this statement can be misleading. While eating disorders can impact any body, historically not every body has had a seat at the table. Black, Indigenous and People of Color (BIPOC) are frequently underrepresented in terms of diagnosis and treatment. Among Black people in particular, eating disorders themselves might not discriminate; but significant barriers exist in terms of diagnosis and treatment.
This year, as in year’s past, the culmination of Black History Month coincides with the National Eating Disorder Association’s Eating Disorder Awareness Week (NEDAW). This year’s NEDAW theme is “Every Body Has a Seat at the Table.” As the National Eating Disorders Association (NEDA) states, “This NEDAwareness Week, we invite Every Body to Have a Seat at the Table. In a field where marginalized communities continue to be underrepresented, we welcome conversations on raising awareness, challenging systemic biases, and sharing stories from all backgrounds and experiences.”
Reasons is passionate about increasing awareness of eating disorders within marginalized communities. Shining a spotlight on marginalized voices is, and has always been, an integral part of our philosophy. We are inspired to see the broader eating disorder treatment and recovery community focusing this year’s NEDA Week on this important conversation. With that intersection in mind, we want to place attention especially upon eating disorders within the Black community.
Considerations on eating disorders within the Black community:
- Research as recent as 2014 misguidedly states that eating disorders are more common among white women than women of color, and that anorexia is more common among white women than it is among Black women. These findings are grossly flawed and do not capture the biases and barriers that prevent eating disorder diagnosis among Black people. In fact, these findings are examples of the deep-seated racial bias and stereotypes that bar Black bodies from adequate access to care.
- Within and beyond the world of eating disorders, racial bias drastically impacts Black people in healthcare settings. Sadly, BIPOC experience more illness, worse outcomes and premature death as compared to white populations. Black people also experience less accurate and complete diagnoses for conditions. Even hospital algorithms have been found to discriminate against Black people in terms of access to care for critical illnesses. Within the world of eating disorders, healthcare providers are less likely to recognize eating disorder behaviors among Black populations than any other race. These diagnostic failures are nothing short of life-threatening racial discrimination.
In the context of treatment, much work remains to be done to adequately acknowledge and account for the impact of racial discrimination and marginalization. Our bodies internalize our experiences, including experiences of racism and discrimination. At Reasons Eating Disorder Center, our approach to eating disorder treatment focuses on creating a safe, inclusive space for people of all backgrounds to have a voice in their treatment. Among Black patients, this approach can include exploring the intersection of a person’s identity with their experiences of racism and discrimination and acknowledging the stress of racism on the person’s life. Stress – through racism and in all forms – can increase risks for disordered eating behaviors.
While eating disorders do not discriminate, the impact of race in diagnosis and treatment cannot be ignored. To ensure that Every Body Has a Seat at the Table, we must first acknowledge that many bodies have been consistently underrepresented at the table – including, but not limited to, Black bodies. Though we cannot undo the many mistakes and wrongs of research, diagnostics and treatment of the past, we can shape a different present and future. Acknowledge how racism and racial discrimination have, and still do, prevent adequate access to eating disorder diagnosis and treatment. Share what you learn. Insist upon diverse voices in the eating disorder treatment and recovery community. Settle for nothing less.