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.