When most people think of someone with an eating disorder, they probably picture a young, thin middle-class white woman. There’s a reason for that: we have a long way to go in debunking the mythology around who actually gets eating disorders. The reality is that eating disorders affect people across all body sizes, ages, genders, sexual orientations, socioeconomic statuses, races, and ethnicities. And as a Latina registered dietitian, I’m especially passionate about increasing awareness of the prevalence and treatment of eating disorders among Latinas.

Eating disorders: a white issue?

Unfortunately, eating disorders are stereotypically viewed as a white, middle to upper class issue. This generalization is not only false, but it’s damaging and dangerous – it contributes to people of color being under-reported and undiagnosed. That means plenty of people in desperate need of care either don’t believe they fit the criteria for an eating disorder (and therefore don’t believe that they merit help), or those in their communities — including medical professionals — don’t consider them to be the “type” of people to have eating disorders. In either case, these individuals aren’t getting the support and treatment they need. Although there is a lot more research to be done on eating disorders in marginalized communities, existing studies have shown that eating disorders occur at similar rates in Latinas compared to non-hispanic whites, specifically bulimia nervosa and binge-eating disorder.

There are a lot of reasons why these rates are what they are, and researchers are still trying to make sense of the numbers. But everything from exposure to mainstream American culture and its emphasis on thinness to socioeconomic disparities could play a role. Diving into the possible factors that drive these numbers can help illuminate the work that needs to be done in the research field, treatment settings, and in the community.

Conflicting beauty ideals

Being Latina and living in the U.S. means living between two cultures and trying to constantly navigate between and balance different types of food, music, and family cultures. Latinas are also often confronted with the tough reality of existing between varying — and sometimes conflicting — beauty ideals. That means that the physical traits that may be coveted or considered “beautiful” in Latin American culture are at odds with the Eurocentric beauty ideal that’s often celebrated in America. In most cases, neither type of “ideal” is attainable, and trying to fit the impossible standards of both can be triggering to someone at risk for an eating disorder.

Conflicting food messages

Another often overlooked area that may predispose Latinas to eating disorders is actually more obvious than many people realize: the kitchen. Within Latin American culture itself, food messages can be conflicting and confusing: on the one hand, our families often encourage us to “eat, eat, eat!” and we’re raised to interpret food as a symbol of love that’s central to our culture and family time. In fact, many Latinas may be familiar with the scenario of politely refusing seconds, only to endure their abuela’s pained reaction, as if the refusal is a sign of rejection or an offensive display of bad manners.

But, on the flip side of all that food celebration is a stigma around weight gain. Many Latinas are familiar with the humiliation of being labeled “gorda” (meaning “fat” in Spanish) if they’ve gained any weight at all. And unfortunately, setting boundaries around this language can be tough since we are taught to respect our mamás and abuelas. That means many have had to endure the embarrassment silently.

Mental health: estas loca!?

Another major factor to consider when analyzing the prevalence of eating disorders among Latinas is the fact that mental health is often still a taboo topic in the Latin American community. Our grandparents and even our parents might not be familiar with mental health issues and may label people as “loco” (i.e. “crazy”) if they admit to struggling with a mental health issue. They may be more inclined to recommend a home remedy (“vivaporu” anyone?) because physical ailments may be easier to accept and understand than mental ones. That mentality makes it tough or even impossible to advocate for oneself, meaning many Latinas may be hiding their mental health challenges for fear of facing the cultural sigma head on.

The Underlying Issues

Although eating disorders manifest as food and body issues, they are mental health issues. In fact, they are among the deadliest of mental illnesses. There are underlying psychological issues that spark this serious disordered behavior that we’re still learning about. Among Latinas specifically, the internal conflict of being a member of a marginalized community in the U.S. may be a contributing factor in the development of an eating disorder. The lack of feeling understood and valued as someone from a marginalized group may be one of many triggers, as it can cause feelings of isolation and inadequacy; the disordered behaviors may be an attempt to blend in with the white majority.

At Equip, we are committed to making care more accessible. Having providers with various lived and professional experiences as well as various identities is key in being able to address a diverse range of patients’ needs. This is one of the main reasons why I decided to get into this field. I knew that in order to provide the best care to patients from diverse cultural backgrounds, we needed more representation in the field. We need more providers who can understand marginalized patients’ lived experiences, and who can bring cultural humility into treatment. If you or someone you know is having a hard time addressing their eating disorder for any number of reasons, Equip is here to offer support.