Our culture stereotypes what an eating disorder looks like. If you say the word “eating disorder”, most people will visualize a cis-gender, white, economically privileged, slim and able-bodied, adolescent female struggling with not eating enough food. This stereotype simply misses a large portion of clients that are struggling with eating disorder behaviors.

As eating disorder professionals, we have seen people of all shapes and sizes, races, ethnicities, disabilities, sexualities, genders, and ages. We also know the there are many different eating disorder behaviors. In fact, binge eating disorder is at least 3 times more common than anorexia and bulimia, combined. To be frank, our practice knows that eating disorders don’t have a stereotypical look, and we validate how harmful this myth is to so many. So many people delay getting help because they do not think they belong in eating disorder treatment.

Allison Milch, an Eat With Knowledge dietitian, is passionate about respecting the many different intersections of identity within eating disorder treatment. She is passionate about social justice within the eating disorder space, and ever since she came to the practice, she had many suggestions for us to improve our accessibility and respect to clients that have different identities than our lived experiences. Allison wrote the following to help increase awareness about how harmful the typical “eating disorder stereotype” can be.

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Debunking the Eating Disorder Stereotype

How did the eating disorder stereotype even come about?

First, we acknowledge that the eating disorder field, Eat With Knowledge included, consists of mostly privileged, white, cis-gender, straight-sized women. Mostly white women access eating disorder treatment, and research predominantly centers around white women suffering from anorexia nervosa. The media usually gives air time to white female celebrities suffering from eating disorders. It becomes “normal” for some to seek eating disorder treatment, and “unusual” for others to be struggling with an eating disorder. All of these factors (and more!) contribute to the ongoing narrative of “who” actually struggles with eating disorders.

The research is slowly starting to catch up, although it’s far from perfect.

Here are a few eye-opening statistics from the NEDA website. NEDA has been criticized in the past for not being inclusive of the lived experiences of marginalized identities. As a whole profession, we have a long way to go to make sure the needs of all people are being met when treating eating disorders.

• Despite similar rates of eating disorders among non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, people of color are significantly less likely to receive help for their eating issues.
• 15% of gay and bisexual men and 4.6% of heterosexual men had a full or sub-threshold eating disorder at some point in their lives.
• Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior, such as binging and purging.
• Teenage girls from low-income families are 153% more likely to be bulimic than girls from wealthy families.
• In a survey of college students, transgender students were significantly more likely than members of any other group to report an eating disorder diagnosis in the past year.

We also recognize that professionals have a bias:

• When presented with identical case studies demonstrating disordered eating symptoms in white, Hispanic and African-American women, clinicians were asked to identify if the woman’s eating behavior was problematic. 44% identified the white woman’s behavior as problematic; 41% identified the Hispanic woman’s behavior as problematic, and only 17% identified the black woman’s behavior as problematic. The clinicians were also less likely to recommend that the African-American woman should receive professional help.

Feeling discouraged? We hear you. Feeling angry at the system? We hear you.

We know that there are limitations to how we practice, given our privileged social identities.

With that said, we validate that our practice may not be the best fit for everyone, and it is our goal to steer our clients in a more helpful direction if a client wants to see a clinician with a similar lived experience as them. This is totally normal and we respect it! 

At the same time, we are dedicated to understanding our client’s experiences.

We take the approach of being not only teachers, but learners as well. Our clients are the experts and the work we do together is about the client’s story. We not only believe that people should recover from their eating disorders, but we believe in dismantling diet culture and other forms of systemic oppression. And at the end of the day, we hope to empower our clients to reject diet culture, too.

Eat With Knowledge has worked with over 1,000 clients in the past 10 years.

The bottom line is that no matter what your story is, we are here to listen with open arms. Email us if you are looking for nutrition counseling for yourself or someone you know. As always, if we are not the best match for you we will send you other dietitian recommendations!