Eating Disorders in BIPOC Communities
Despite having no basis in reality, the stereotype that eating disorders only affect white, thin, affluent girls is alive and well. This belief is pervasive in both the general population and among healthcare professionals, and it continues to cause harm to the many BIPOC people struggling with eating disorders. The term BIPOC stands for Black, Indigenous, and people of color, and it encompasses a wide range of different cultures, races, and ethnicities. BIPOC individuals are just as likely as their white counterparts to develop an eating disorder—but are half as likely to be diagnosed or get treatment. There are a few reasons for this imbalance. First, stereotypes can be incredibly powerful, even if they’re subconscious. Friends, family members, and medical professionals may never even consider that someone has an eating disorder because they don’t look like the “type” of person affected by one. There’s also the fact that the bulk of eating disorder research utilizes predominately white samples, often shutting BIPOC communities out of the conversation. That leaves the vast majority of clinicians without a clear sense of how to recognize and treat eating disorders in these populations. BIPOC people also face unique risk factors for developing an eating disorder: racism, xenophobia, microaggressions, Eurocentric beauty standards, and a sense of not belonging all act as catalysts for an eating disorder to take hold. But with culturally competent care and an understanding that eating disorders affect people of all races and ethnicities, we can move toward closing the treatment gap and getting effective treatment to every BIPOC person with an eating disorder.

Facts and statistics about eating disorders in BIPOC communities:

  • Research shows that 20-26% of those affected by eating disorders are BIPOC people, indicating that BIPOC people are as likely as their white counterparts to develop eating disorders.
  • BIPOC individuals with eating disorders are half as likely to be diagnosed or to receive treatment.
  • BIPOC individuals are significantly less likely than white people to have been asked by a doctor about eating disorder symptoms.
  • Latinx and Native American patients with eating disorders are significantly less likely than white patients to receive a recommendation or referral for further evaluation or care.
  • Black teenagers are 50% more likely than white teenagers to exhibit behaviors of bulimia, and Hispanic people are significantly more likely to suffer from bulimia than their non-Hispanic peers.
  • One study found that Hispanic girls reported significantly greater body dissatisfaction than white girls and may be at a greater risk for adopting eating disorder behaviors than previously thought.
  • Young black girls are just as likely as young white girls to report binge eating or vomiting, and even more likely to report fasting and abuse of laxatives or diuretics.
  • Research has found that Asian American women demonstrate higher rates of disordered eating than other women of color, as well as higher rates of food restriction and purging as compared to their white peers.
Common questions about eating disorders in BIPOC communities

BIPOC people slip through the cracks of eating disorder treatment for a number of different overlapping and insidious reasons. Here are some of the biggest ones:

  • Stereotypes about who gets eating disorders. Though awareness is starting to increase about who really gets eating disorders, decades of media depictions have led millions of people to assume that only thin, white, affluent girls get eating disorders. This misconception—which research has continually shown is false—leads both healthcare professionals and loved ones to miss eating disorder signs in BIPOC people. In fact, one study found that clinicians were less likely to diagnose a fictional character with an eating disorder if they were African-American rather than white.
  • Gaps in the research. The vast majority of eating disorder research uses white subjects and is written through a white lens. This means that information is sorely lacking on the unique ways that eating disorders show up in BIPOC populations.
  • Stigma within the community. In many BIPOC communities, mental health issues may be treated as taboo, making it harder for those struggling to reach out for help.

Underdiagnosis is one of the biggest barriers to treatment for BIPOC people, and the same factors that fuel underdiagnosis (stereotypes, lack of research, and stigma) can present challenges in treatment. BIPOC people may also face other hurdles to effective treatment:

  • Language barriers. Some BIPOC patients or their families may speak a language other than English, which is the most common language utilized by treatment teams in the United States. How can you begin to get effective care if your treatment team is not able to speak your language?
  • Cost of care. Eating disorder treatment can be prohibitively expensive for people of any race, but because of racial wealth gaps, it may be more common for BIPOC families.
  • Cultural ignorance. Many eating disorder clinicians lack awareness about cross-cultural differences in terms of nutrition, dietary choices, values, and more. This can lead to treatment recommendations that just don’t work, and patients who feel alienated from their care team.
  • Lack of diversity. It’s not uncommon for both providers and patients in eating disorder treatment settings to be all white. This lack of racial and ethnic diversity can impede care, as both patients and their family members may feel like they don’t belong or that their clinicians can’t understand their experience.

To best support a BIPOC person struggling with an eating disorder, it’s important to help them navigate all the challenges laid out above. This means remembering that eating disorders don’t have a “look,” and they, like any patient population, deserve access to culturally responsive care.

Eating disorders affect BIPOC communities at the same rate that they affect white communities, and a BIPOC person can have any type of eating disorder. However, research has suggested that some eating disorder diagnoses may be more common in certain populations.

Research shows that Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior, like binge eating and purging. Another study found that among Black adults and adolescents, anorexia was the rarest eating disorder while binge eating was the most common.

According to one study, among Latinx populations, there are elevated rates of binge eating and binge eating disorder but low prevalence of anorexia nervosa and bulimia nervosa. Research has also found that Asian Americans have higher rates of disordered eating than other BIPOC groups.

It’s important to take all of this with a grain of salt: the research is very limited, and every type of eating disorder exists across every race.

How Equip supports BIPOC populations

Eating disorders don’t discriminate, but, at least historically, eating disorder treatment has. At Equip, we’re striving to reverse that. Currently, 30% of Equipsters are BIPOC. We also have specific resources tailored to BIPOC patients and their families, including BIPOC and Spanish-speaking support groups as well as the ability to provide services in any language. We know that having a diverse provider team is one of the first steps toward better serving BIPOC communities, and we work to ensure that our staff represents the patients they serve.
If you think you or a loved one may be struggling with an eating disorder, finding prompt and culturally competent treatment is vital.
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