Racial disparities in ED Treatment
Updated: May 9
Hey there! I hope you are staying as safe as you can during this challenging time. It’s been a minute since my last blog post, and while I may have been more quiet on here than in past months, I've been excited and motivated by my hardworking clients, supportive family and peers, and the uptick in attention to mental health in the media. It feels refreshing to see mental health and eating disorders become less stigmatized, and I look forward to seeing these causes get the awareness they deserve.
While I am happy to see more attention, money and research dedicated to eating disorders and recovery, I am still disappointed by the lack of representation. Despite statistics proving that eating disorders impact people of all body sizes, ages, races, gender identities, sexualities and socioeconomic classes, the vast majority of research and representation still centers on thin, white, upper class women. I’ve spoken on the blog before about underrepresentation in the eating disorder community, namely in the LGBTQ+ community and the Latina community. In honor of February being Black History Month, I would like to spend time today on eating disorders impacting Black women and girls.
As a white, straight-bodied, female clinician, I realize that I look like the stereotypical eating disorder client. I have benefited from the unearned privileges my identity has granted me, as both an eating disorder client and clinician. My identity has given me access to high quality care and validation of my symptoms that so many others have been (and still are) denied. My goal in this blog post is not to diminish the hardships that women who look like me may face in their recovery journey, but rather to raise awareness and call to action for those who don’t. Regardless of identity and background, those who are struggling deserve confirmation and adequate care.
Despite the myth that eating disorders only impact white women, the rates of eating disorders among Black women are staggering. A 2011 study found that Black teenagers are 50% more likely to exhibit symptoms of bulimia nervosa compared to their white peers (Goeree, Ham, & Iorio, 2011). A 2007 study found that binge eating disorder is the most common eating disorder among Black adults and adolescents (Taylor, Caldwell, Baser, Faison, N., & Jackson, 2007). More research has shown that binge eating disorder occurs in almost 5% of the Black female population, and could be as high as 30% in those in fat bodies (Goode, Cowell, Mazzeo, Cooper-Lewter, Forte, Olayia & Bulik, 2020). Further, eating disorders are commonly used as a coping mechanism for trauma. Studies show that Black women experience traumatic events at disproportionately higher rates than their white counterparts, making them more vulnerable to mental illnesses such as eating disorders.
Furthermore, Black women face unique barriers to treatment. Because of stereotypes about who is impacted by eating disorders, minority groups are often mis- and undiagnosed. A 2006 study asked healthcare professionals to assess and diagnose Mary, a fictional character who exhibited eating disorder behaviors. Mary’s racial identity was manipulated across trials; the study examined her treatment as a white patient, a Hispanic patient, and a Black patient. The study found that when Mary was Black, only 17% of clinicians detected eating disorder behaviors, compared to 44% when Mary was white and 41% when Mary was Hispanic (Gordon, Brattole, Wingate, & Joiner, 2005). Biases in the medical field are a major barrier to quality care, and prolong the stigma about who is impacted.
Unfortunately, most healthcare providers are not appropriately educated on diagnosing eating disorders other than anorexia nervosa, especially when the client does not fit the stereotypical mold. While binge eating disorder is the most common eating disorder in the United States and the most common eating disorder in the Black community, it is largely unnoticed and undiagnosed by healthcare professionals, leaving clients to be left untreated. The longer symptoms go untreated, the worse they are likely to get, often resulting in other medical issues and worsen mental health.
Systemic racism is a major determinant in who gets quality healthcare, as well as who has access to well paying jobs, better food choices, and affordable housing. These factors, among others, contribute to overall mental and physical health. As a member of the mental health and healthcare community with unearned privilege, it is my duty to amplify marginalized voices. Black women deserve quality care. Period. Healthcare professionals must demand the conduction of more inclusive research and prioritize individualized care. Our shortcomings are even evidenced by how outdated the studies cited in this post are. In the eating disorder community, we must highlight the discrepancies that have been overlooked for far too long. In addition to urging providers to do their part in bridging the gap, I would also like to highlight some incredible resources:
Hood Feminism by Mikki Kendall
Not All Black Girls Know How to Eat by Stephanie Covington Armstrong
We have immediate openings right now for eating disorder therapy in:
Delaware, New Jersey, Florida, and Pennsylvania.
And recovery coaching worldwide.
Click here to get started with therapy today! : https://www.recoveredandrestoredtherapy.com/.
Recovered and Restored is an eating disorder therapy center founded by Gabrielle Morreale. We specialize in helping teens and young women heal from eating disorders such as anorexia, bulimia, orthorexia, and binge eating disorder and treat disordered eating, anxiety, depression, and PTSD. We provide eating disorder therapy in the towns of Horsham, Upper Gwynedd, Lower Gwynedd, North Wales, Lansdale, Hatfield, Blue Bell, Doylestown, and nearby towns with eating disorder therapy. Also providing virtual eating disorder therapy in New Jersey, Delaware, and Florida. Some towns served virtually but are not limited to Pittsburg, Lancaster, Harrisburg, Center City, Cherry Hill, Haddonfield, Mount Laurel, Cape May, Avalon, Brick, Dover, New Castle, Bethany Beach, Marydel, and Oceanview.