{"id":18825,"date":"2020-08-26T12:07:09","date_gmt":"2020-08-26T17:07:09","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18825"},"modified":"2023-03-06T09:49:50","modified_gmt":"2023-03-06T14:49:50","slug":"the-quest-to-make-eating-disorder-treatment-more-inclusive","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/healthcare-trends\/the-quest-to-make-eating-disorder-treatment-more-inclusive\/","title":{"rendered":"The Quest to Make Eating Disorder Treatment More Inclusive"},"content":{"rendered":"

When Stephanie Covington Armstrong was in the deepest throes of bulimia, vomiting up to 10 times a day and \u201ccompletely unable to function,\u201d she saw a newspaper ad for an eating disorder study. \u201cIf you are struggling with bulimia, we can help,\u201d it said. She decided the time was right to finally seek treatment.<\/span><\/p>\n

\u201cI went to this intake program at this fancy hospital, and they were looking at me like I was a purple, two-headed giraffe,\u201d she says. Armstrong, who lives in Los Angeles, was the only Black person in the room. \u201cDid I need to say, \u2018I only throw up fried chicken and watermelon?\u2019\u201d While she continued with the program, she still wrestled with powerful urges to throw up. <\/span>\u201cI knew they weren\u2019t going to help me. They were too fascinated with me as a Black woman, [rather] than as just another person with bulimia.\u201d<\/span><\/p>\n

Armstrong\u2019s<\/span> experience, which she documented in her book <\/span>Not All Black Girls Know How to Eat<\/span><\/i><\/a>, is echoed by<\/span> many people of color who seek help for eating disorders; an even greater number never reach out for treatment, often because they don\u2019t know there\u2019s a reason to.\u00a0<\/span><\/p>\n

Eating disorders are typically depicted as a white woman\u2019s disease. A Google image search for \u201ceating disorders\u201d yields a sea of photos (and some illustrations) of light skin. <\/span>Websites<\/span><\/a> for eating disorder treatment centers are dominated by <\/span>white faces and bodies<\/span><\/a>, both in patient testimonials and <\/span>stock photos<\/span><\/a>. This stereotype also infiltrates research; most of the science on eating disorders is based on the study of white girls and women.<\/span><\/p>\n

But the limited research that does include people of color supports growing evidence that eating disorder rates are similar across racial and ethnic groups. <\/span>One study<\/span><\/a> found that Black women were as likely to report binge-eating and vomiting as their white counterparts. Some studies have found that <\/span>Black<\/span><\/a> and <\/span>Hispanic teenagers<\/span><\/a> are more likely than white ones to have bulimia. Even so, people of color who voice concerns about eating or weight to their doctors are <\/span>less likely to receive follow-up questions<\/span><\/a> about eating disorder symptoms.<\/span><\/p>\n

“Just because we don\u2019t want to look like Farrah Fawcett doesn\u2019t mean we don\u2019t want to look like Beyonce.”<\/span><\/p><\/blockquote>\n

\u201cThere\u2019s still the idea that you have to be an emaciated white woman to have an eating disorder,\u201d says Dr. <\/span>Lesley Williams<\/span><\/a>, a physician and eating disorder specialist. On top of that, there\u2019s a misconception that \u201cwomen of color are immune to eating disorders because they come from communities that tend to be more accepting of body size diversity.\u201d<\/span><\/p>\n

\u201cJust because we don\u2019t want to look like Farrah Fawcett doesn\u2019t mean we don\u2019t want to look like Beyonce,\u201d says Joy Arlene Renee Cox, a researcher, body justice advocate and author of <\/span>Fat Girls in Black Bodies<\/span><\/i><\/a>. In the 2019 autobiographical documentary <\/span>Homecoming<\/span><\/i>, Beyonc\u00e9 talks candidly about resorting to extreme weight-loss tactics, including a diet so dangerously low in calories that nutrition experts subsequently <\/span>warned people<\/span><\/a> to stay away from it. \u201cI\u2019m hungry,” Beyonce admitted in the movie.<\/span><\/p>\n

Beyonc\u00e9 might have the power to single-handedly define beauty ideals, but that doesn\u2019t mean she\u2019s immune to the pressure of living up to them, Cox points out. In other words, even Beyonc\u00e9 faces pressure to change her body to \u201clook like Beyonc\u00e9.\u201d\u00a0\u00a0<\/span><\/p>\n

\u201cBeyonc\u00e9 is beautiful. She\u2019s a beautiful person, she makes beautiful music. But even Beyonc\u00e9 doesn\u2019t have that much liberty to just kind of <\/span>be<\/span><\/i>,\u201d says Cox. \u201cIf Beyonc\u00e9 wanted to gain 60 pounds and said, \u2018This is me and I\u2019m good with it,\u2019 you would have a problem with the brand.\u201d<\/span><\/p>\n

Diet culture sets a potentially dangerous backdrop for people who are vulnerable to disordered eating<\/span>. But Armstrong emphasizes that her own eating disorder was more of a coping tool than a means of achieving a specific body type.<\/span><\/p>\n

\u201cI think what people get wrong is that when Black women have an eating disorder, it has a lot less to do with trying to look like a white woman than people think,\u201d she says. \u201cThat doesn\u2019t even come into play. We don\u2019t want to be skinny and white. We just want to loosen the valve of trauma pressure. I had all these deep wounds and pain, and I had no coping mechanism. Food and my body was something I could focus and obsess on and try to change. And if I could change that, then I would be safe.\u201d<\/span><\/p>\n

While in general, coping mechanisms and control are common themes underlying eating disorders, the mental health impacts of racism cannot be overstated, according to many eating disorder survivors and experts of color.<\/span><\/p>\n

\u201cRacism is a daily trauma,\u201d says Armstrong, \u201cthe day-to-day of getting through the world as a Black woman. If you\u2019re white with bulimia, it\u2019s not that you don\u2019t have high levels of trauma, but one of them isn\u2019t racism.\u201d<\/span><\/p>\n

Eating disorders have the <\/span>highest mortality rate<\/span><\/a> of any mental illness.<\/span><\/p><\/blockquote>\n

Anecdotally, among her patients who are women of color and struggling with eating disorders, Williams says \u201cninety-nine percent of them had a history of some type of trauma,\u201d including racial trauma.\u00a0 Now she worries about new challenges and vulnerabilities related to the pandemic.<\/span><\/p>\n

\u201cYou\u2019re stuck in the house, you\u2019re being retraumatized every time you turn on the television, having to emotionally navigate video footage not only of George Floyd\u2019s murder,” but also reports of nationwide police brutality, coronavirus numbers and bleak economic forecasts, says Williams, \u201cand the one thing you have access to is an environment where your eating disorder can flourish.\u201d<\/span><\/p>\n

Eating disorders have the <\/span>highest mortality rate<\/span><\/a> of any mental illness. Someone dies as a direct result of an eating disorder <\/span>every 62 minutes<\/span><\/a>.\u00a0<\/span><\/p>\n

That\u2019s why, from a public health perspective, it\u2019s crucial to include people of color in studies, as well as account for geographic and socioeconomic diversity within those populations. \u201cMoney and resources are put where the need is, and if the need isn\u2019t identified, then there won\u2019t be money or resources invested,\u201d Williams says. \u201cYou can\u2019t look for eating disorders in only one swath of the patient population.\u201d<\/span><\/p>\n

Now in recovery, Armstrong works as an eating disorder educator and advocate. \u201cI\u2019ve talked to girls in South Central [Los Angeles] and other underserved communities, and they\u2019re struggling with bulimia, compulsive eating, remnants of childhood trauma and sexual abuse,\u201d she says. \u201cUnless people are educated about what an eating disorder is, you won\u2019t know you have an issue.\u201d<\/span><\/p>\n

Williams often sees patients who exhibit clear symptoms of eating disorders but don\u2019t acknowledge it. \u201cIt\u2019s having the frank conversation: Maybe the weight you\u2019re trying to maintain is not what is natural for your body, because you\u2019re having to do all these things. Maybe we can explore what a natural place for your body and a healthy relationship with food would look like.\u201d<\/span><\/p>\n

To Cox, these kinds of conversations are imperative for patients to begin healing. “What needs to happen is relationship-building,” she says. In order to do that, white researchers and healthcare providers must approach patients of color with a genuine desire to understand and help them. “There’s been a lot of black people being studied by this outsider looking in, and it’s not enough,” she says. “Aside from studying me, do you really want to know who I am as a person?”<\/span><\/p>\n

For patients of color frustrated by feeling unseen, Cox recommends asking for a different practitioner. \u201cOften in the Black collective, we feel we don\u2019t have choices, but know that you have agency in choosing,\u201d she says.<\/span><\/p>\n

She advises people to find a community somewhere, even on social media. Organizations like Nalgona Positivity Pride<\/a> offer resources and support, such as the monthly online discussion and peer support group <\/span>Sage and Spoon<\/span><\/a>. The National Eating Disorders Association has also compiled a list of <\/span>mental health and wellness resources<\/span><\/a> specifically focused on the experiences of those who are Black, Indigenous and people of color.<\/span><\/p>\n

\u201cIt can be extremely isolating to be in a space where you feel you don\u2019t have support,\u201d Cox says. \u201cBut you\u2019re not alone in feeling like that, and you\u2019re not alone in experiencing what you\u2019re experiencing, and it may require more on your part. Don\u2019t stop knocking on doors. There is support, and people are speaking out on behalf of Black people. The hope is out there.\u201d<\/span><\/p>\n

\n

*<\/span>If you or someone you know is struggling with an eating disorder, you can call the\u00a0<\/span><\/i>National Eating Disorders Association\u00a0Helpline<\/span><\/i><\/a>\u00a0at 1-800-931-2237, text “NEDA” to 741-741 or\u00a0<\/span><\/i>click to\u00a0chat<\/span><\/i><\/a>.\u00a0<\/span><\/i><\/p>\n

\n

Ready to book a doctor’s appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

Too often, eating disorders are still depicted as a white woman\u2019s disease. <\/p>\n","protected":false},"author":11,"featured_media":18826,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[229],"tags":[158,41,155],"class_list":["post-18825","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare-trends","tag-eating-disorders","tag-mental-health","tag-race","reviewer-dr-nassim-assefi","specialist_by_city-therapists"],"yoast_head":"\nThe Quest to Make Eating Disorder Treatment More Inclusive - Healthcare Trends<\/title>\n<meta name=\"description\" content=\"Too often, eating disorders are still depicted as a white woman\u2019s disease.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/healthcare-trends\/the-quest-to-make-eating-disorder-treatment-more-inclusive\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Quest to Make Eating Disorder Treatment More Inclusive - 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