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5 Things You (Maybe) Didn’t Know About Eating Disorders

By Laura Porter--Fill in the blank: “______ has an eating disorder.”

What words do you associate with that blank? Maybe “she,” “my sister,” “my mother,” or maybe “he” or “my brother?” If you asked a random stranger, or even someone you know, to fill in the blank what do you think would come to mind? For most people, without even thinking, a young, white female would probably be the answer. This is why we’ve put together five facts about eating disorders in marginalized communities: to break some of the all-too-common stigmas we perpetuate daily.

1. Eating disorders are mental illnesses. Just like other mental health conditions, such as depression and anxiety, they can affect anyone.

Eating disorders are isolating, shame-ridden and painful. They don't manifest in a vacuum. They are complex conditions that arise from a combination of long-standing behavioral, biological, emotional, psychological, interpersonal and social factors. When we portray eating disorders as a "choice," we are not only perpetuating a clear misunderstanding of these illnesses--we are also furthering self-stigma and shame.

Women and men of color can face fear of judgment from their communities if the popular belief continues to be that eating disorders only affect white girls. "There is that shame of not being a strong Black woman,” Stephanie Covington Armstrong, author of Not All Black Girls Know How to Eat, said “People would ask me, 'What, do you want to be white or something?’” a comment that exemplifies the necessity of understanding the cultural contexts in which eating disorders manifest.

2. Anyonethis includes individuals of varying socioeconomic status.

Eating disorders affect both working-class and impoverished individuals. Despite this truth, we continue to live in a media environment that almost exclusively churns out sensationalized stories of white female celebrities living with eating disorders. With this flux of narrow, one-dimensional representations of eating disorders, it is hard not to internalize the belief that eating disorders only happen in middle- and upper-class communities. What we see, however, is a commodified construction of reality--bits and pieces of information warped or twisted to sell magazines.

So here’s the actual reality.

One study showed that teens from low-income families were 153 percent more likely to be bulimic than girls from wealthy families. This is not common knowledge. Benji Young, a transmale psychology student living in poverty, spent time in class flipping through the pages of a textbook chapter on eating disorders, searching for a paragraph or section that reflected his experience. Instead, Young kept seeing female pronouns used over and over again, and a very narrow (if not completely uniform) demographic of who develops eating disorders: “a middle-class or wealthy white female between 14 and 18 years old.” Young isn’t an “exception to rule,” nor is he alone. He is one of many voices speaking out to bust the “white girl disease” myth.

3. There is a huge need for clinicians to obtain cultural competency when it comes to treating eating disorders in marginalized populations.

Luke Knudsen, a queer transman, wrote about the stigma he’s faced not only from societal beliefs, but also from a provider from whom he was seeking help. The provider, lacking the cultural competency and understanding to treat Knudsen, said “Honestly? I can help you as a transgender person or as a person with an eating disorder. I’m not really sure how to combine the two.” Knudsen is not one or the other, he is both: a transman with an eating disorder. Clinicians need to be able to navigate the experiences of all people living with these illnesses, especially in the LGBT community. One recent study showed that the prevalence of eating disorders among transgender college students, at 15.82%, was much greater than the 4% prevalence in cisgender male or female peers. Clinicians working in the eating disorder field need to treat the whole person by understanding the unique cultural contexts of each individual’s situation.

4. Marginalized communities are less likely to use mental health services, in large part because clinicians often hold stereotypical views of what eating disorders “look like.”

While it’s becoming increasingly accepted that everyone can be affected by eating disorders--regardless of race, sexual orientation, gender, ethnicity, socioeconomic status or other differentiating factors--there still exists inequity in use of treatment services. Researchers believe that this inequality is based, at least in part, on clinicians’ biases. Gordon et al. (2006)[1], note that “clinicians may have race-based stereotypes about eating disorders,” seeing these illnesses as primarily affecting young, white women. These race-based stereotypes have huge implications in terms of who can access mental health services. When clinicians are less likely to identify and diagnose racial minorities, including African American, Latino and Native American patients (Becker, et al. 2003)[2] with an eating disorder, it perpetuates this harmful, widespread stereotyping, while also creating a barrier to the necessary therapeutic treatment of these diseases.

5. There is so much power in stories that expose biases in the way we view eating disordersand these stories need to be heard.

As a college-aged, white, cisgender woman, I enter into this discussion with inherent privilege. I have seen myself represented in stories, articles and talks on eating disorders. I am the demographic who has been the most recognized and studied in scholarly research. I am not the one to talk about the experiences of those historically left out, papered over and unacknowledged in the eating disorder community. We need to hear these stories, your stories, with open ears and minds. Your story, whatever it may be, has power. As a community involved in eating disorder awareness, advocacy, research or treatment, we must continue to magnify these stories and engage in a new dialogue about eating disorders—a dialogue where we are not afraid to acknowledge the voices that have been left out, and where we commit to magnifying these marginalized voices, so that everyone who’s struggling knows that they are not alone.

To read stories from people of marginalized identities, check out NEDA's Untold Truths: The Marginalized Voices Project.

About the blogger: Laura Porter is a student at George Washington University majoring in political communication with a minor in psychology. After taking three semesters off of school for her own mental health struggles, Laura became passionate about advocating for increased awareness of mental illness among college students, specifically eating disorder awareness. Laura served as president of Students Promoting Eating Disorder Awareness and Knowledge at GW (SPEAK GW) as well as a communications intern at Active Minds Inc. 

Also by Laura:

5 Things I've Learned in Recovery (As Told Through Broad City GIFs)

5 Ways to Advocate and Promote Awareness on your Campus

Taking Up Space: An Interview with Beck Cooper

Never Stop Fighting for Recovery

 

[1] Gordon, Kathryn H., et al. "The Impact of Client Race on Clinician Detection of Eating Disorders." Behavior Therapy 37.4 (2006): 319-25. Web.

[2] Becker, Anne E., et al. "Ethnicity and Differential Access to Care for Eating Disorder Symptoms." The International journal of eating disorders 33.2 (2003): 205-12. Web.

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