In honour of Black History Month, we would like to focus on the impact of race and racism on eating disorders. However, it is important to note that this should be a focus all year round as we strive for patient-centred care for all.
Eating disorders have been stereotyped as a condition experienced by ‘thin’ White women. This has resulted in folks of other races, especially Black women, being ignored and this adds to the health disparities they face in our healthcare system.
We often live ‘undiagnosed’ or ‘misdiagnosed’ with eating disorders for many years. As a result, we fail to recognize the signs and symptoms, as healthcare workers ignore these, and we are taught to see these signs as ‘normal.’
Eating disorders do not discriminate…true! However, we must address how race influences the body and food. We must also address the impact of our cultural backgrounds in the development of eating disorders in Black communities. Finally, we must genuinely see and center eating disorders in communities of color to challenge the systemic inequality perpetuated by and within our field.
Visibility of Anorexia Nervosa
Research shows that anorexia nervosa (AN) is more recognizable as an eating disorder than bulimia nervosa (BN) and binge eating disorders (BED) among individuals. This could be because AN symptoms are often more visible and considered life-threatening compared to other eating disorder subtypes. As a result, BN and BED symptoms might be more normalized and go undetected for an extended period. Most research papers on eating disorders in Black folks focus on AN; however, it is time to broaden our lens to the other EDs that have been ignored.
Why Do EDs Go Unrecognized In The Black Community?
As a country that lacks race-based data, especially regarding health status, we cannot quantify the extent of eating disorders among Black individuals. While new research is being developed, we know a few reasons why eating disorders can go unrecognized.
Eating disorders can go unrecognized as a result of the following, but not limited to;
- Access to treatment
- Lack of representation in research
- An incorrect assumption of what ‘thin’ represents
- Lack of representation in the media
- Distrust of the healthcare system
For Clinicians
As a result of systemic racism, BIPOC and marginalized groups who have an eating disorder are less likely to be diagnosed with one and are often hesitant to seek treatment. This can result from the stigma received just for being a Black person or due to institutionalized racism resulting in poverty, food insecurity, etc.
To be culturally informed as a clinician means taking note of these differences and evaluating your practice. For example, are we using images of thin White women when advertising our practice? This alone reinforces the notion that this is the only group that can have eating disorders. Research shows that this stereotype forms the assumption that anyone with an eating disorder has access to private insurance and can afford expensive treatment, which we know is false.
Call to Action
- Strive to create trauma-informed, culturally sensitive, and competent care.
- Provide accessible care for marginalized communities and dismantle the systems that prevent Black clients from accessing eating disorder care.
- Remember that representation matters, and ask how you can diversify your practice to ensure that BIPOC folks feel safe to seek help from you or your clinic.
Eating Disorder Care for Primary Care Providers
If you are a clinician looking to learn more about navigating eating disorder care with your clients, register for our free webinar, First, Do No Harm for Primary Care Providers.
We also offer an online Eating Disorder Care for Health Care Providers (EDC for HCP) course to educate clinicians in primary care about early eating disorder detection and treatment. This course provides clinicians with the foundational knowledge they need to help their patients who are living with eating disorders right away.
