The Truth About Eating Disorders Among Minority Populations

Recent events, combined with advocacy efforts, shed light on the fact that identity plays a large role in mental health. Minority identity is especially important. Minority populations face harmful discrimination, which can be detrimental to their mental health, especially when it happens with frequent occurence.

The reality is, increased stress levels, exposure to trauma, experiences of grief, and other negative emotions that are unfairly and unjustly part of the minority experience can manifest into eating disorders. The lack of resources that are available – including resources that are appropriate for minority populations’ use – act as a barrier for these communities to reach out for help. This, in turn, only exacerbates their mental health and can lead to worse outcomes for their eating disorders.

Eating Disorders Among Minority Populations

There are many reasons why individuals develop eating disorders. Additionally, there are many factors that play into how each eating disorder presents itself. Cultural beliefs about food, body size, and beauty ideals can impact a person’s self-image and their eating behaviors. It can also change how a person goes about seeking help.

It’s not just young white women who develop eating disorders. Eating disorders impact people of all ages, identities, and situations. However, the media commonly ignores the many communities that experience eating disorders outside of that stereotype. This lack of representation can negatively influence how individuals with minority identities see themselves against the stereotype. It also may determine whether or not they reach out for help at all. 

Minority Populations Are Less Likely to Ask for Help

A survey of over 1,700 students correlated gender, race, and socioeconomic status with help-seeking behaviors. Unsurprisingly, individuals with minority identities that had eating disorder concerns had lower rates of reaching out for help than their white, affluent peers.¹ This disparity could be because of their internalization that eating disorders only happen to people who look and live a certain way.

This theory is further supported by a study that revealed that parents of Asian American students largely showed low literacy when it came to mental health.² For instance, only 37 percent of these parents identified antidepressants as being a useful tool to help their child with their mental health concerns. With low support at home, many young people do not seek treatment for their mental illness or eating disorder, making minority students less likely to access mental health treatment than their white peers.

Besides the harmful impacts of stereotypes, there are other reasons that lead to roadblocks when it comes to finding care for an eating disorder. Research completed through focus groups made up of South Asian women in the United States showed that there were several barriers that kept individuals from reaching out for help with their eating disorder. These barriers include social stigma, fear of how mental illness impacts immigration, possible discrimination by medical professional, and more.³ 

How to Improve Accessibility of Eating Disorder Treatment for Minority Populations

With eating disorders affecting people of all backgrounds, identities, and life situations, it’s important for clinicians to improve the accessibility of eating disorder treatment for minority populations. Here are a few ideas to keep in mind:

• Involve family members in treatment. By including parents, siblings, and extended family in conversations about healthy eating, you educate the patient and their support system. This practice might also lead to introspection about cultural practices or assumptions made because of the patient’s identity.
• Use culturally-sensitive resources. Not only should you be using interpreters when working with clients who speak other languages, but you might also consider making sure that all of your resources (including print!) are at an appropriate reading level and make sense to minority patients and their families. Find resources that show patients of all identities to actively fight against the stereotype that eating disorders only affect young white women.
• Talk about family structure, expectations, and roles. A systematic review conducted by researchers recommends understanding and exploring the patient’s cultural context in treatment. This approach ensures that treatment touches on all aspects of a patient’s life.⁴ By talking with your patients about their home lives, you might learn a lot. This approach also gives the patient the opportunity to reflect on their experiences. They can determine what’s helpful and what’s not helpful when it comes to their home situations.
• Include discussions about immigration and acculturation stress. For patients who are from another country or have a minority racial identity, it can be helpful to acknowledge the immense stress of immigration and/or acculturation. This stress can be detrimental towards your patient’s mental health. By giving them permission to talk about their experiences, you might help them process what they’re going through.
• Always be affirming. No matter your patient’s race, cultural background, religion, sexual orientation, or socioeconimc status, using affirming language and putting forth a safe environment in your treatment can go a very long way. Avoid making assumptions about your patients and approach the conversation with respect. If you do slip up in something that you say, be sure to apologize instead of pretending like nothing happened. This approach is backed by a study that showed that eating disorder treatment for transgendered patients was at times more harmful than helpful because of clinician incompetence in understanding and affirming transgender concepts.⁵
• Never stop learning. It’s imperative to continue learning about different cultures, ways of living, and social justice topics. This knowledge will help you when you meet new patients. Moreover, it shows that you’re not only curious about what’s happening in the world but that you’re an advocate for increased accessibility for mental health treatment.

National Minority Mental Health Awareness Month

Every July, we celebrate National Minority Mental Health Awareness Month. Given the lasting impact of the COVID-19 pandemic, it’s more important than ever that racial and ethnic minority groups can access mental health resources and treatment services. At Hidden River, we are committed to providing culturally-specific eating disorder care. We are always looking for ways to better serve our minority patients. We hope you’ll join us in this endeavor!

Visit our website to learn more about eating disorder treatment at Hidden River.

References:

1 Sonneville, K.R., & Lipson, S.K. (2018). Disparities in eating disorder diagnosis and treatment according to weight status, race/ethnicity, socioeconomic background, and sex among college students. International Journal of Eating Disorders, 51(6), 518-526.

2 Wang, C., Do, K.A., Frese, K., & Zhen, L. (2019). Asian immigrant parents’ perception of barriers preventing adolescents from seeking school-based mental health services. School Mental Health, 11, 364-377.

3 Goel, N. J., Thomas, B., Boutté, R. L., Kaur, B., & Mazzeo, S. E. (2022). “What will people say?”: Mental health stigmatization as a barrier to eating disorder treatment-seeking for South Asian American women. Asian American Journal of Psychology.Advance online publication.

4 Acle, A., Cook, B.J., Siegfried, N., & Beasley, T. (2021). Cultural considerations in the treatment of eating disorders among racial/ethnic minorities: A systematic review. Journal of Cross-Cultural Psychology, 52(5), 468-488.

5 Duffy, M.E., Henkel, K.E., Earnshaw, V.A. (2016). Transgender clients’ experiences of eating disorder treatment. Journal of LGBT Issues in Counseling, 10(3), 136-149.