Blog

Why We Need to Talk About Eating Disorders Differently

02/09/2024

September 2nd - 8th is eating disorder awareness week in Australia. The Butterfly Foundation website tells us that 27% of people diagnosed with an eating disorder are under the age of 19: adolescents and children. And the Eating Disorders VIC website says that eating disorder diagnoses are overly represented in Indigenous young people, and can occur across cultures and ethnicities. Yet there is no information based on culture or ethnicity for young people, who form almost a third of all ED diagnoses. If you speak with a clinician working with these populations, the chances are high they will have come across and will be actively working with BIPOC young people and adults who experience disordered eating, if not diagnosed eating disorders. And due to the nature of these conditions, which require multi-disciplinary care and treatment from doctors, mental health clinicians, dietitians, nurses, and others, it can be really difficult to identify young people of colour who struggle with disordered eating but fall through the gaps when it comes to diagnosis and support.

And what can this support look like? Often social media posts and factsheets that are created to increase awareness about eating disorders and educate the public state things like “tell people not to comment on your body!” or “gently remind others not to speak about food habits when you are around.” What is so sorely lacking in these well intentioned messages is any actual critical thought about the impact of culture and society on the person, and how cultural responsivity needs to be built into these resources. Have you ever braved a boundary-setting conversation with an apparently well-meaning South Asian Aunty who will shame someone in public for gaining weight, and ask them to eat some more homemade treats in the same breath? Clearly the people designing these resources haven’t.

Young people often struggle with these situations, where cultural mores prescribe that they treat elders with respect and accept any statements made towards them as good advice. They can also struggle with internalising Euro-centric body image and beauty standards, which they do not fit, and having to constantly live in a world where you are made to feel less-than due to the well-known impacts of systemic discrimination and harm. Adding to the complexity is the fact that often for young people navigating different cultures inside and outside their homes, food is intimately tied to culture and disordered eating. Rejecting a certain food can be rooted in more than just the mainstream understanding of sensory and weight related concerns; it can be an act of breaking away from something they find is a burden, or an act of inadvertent internalised racism. The limited research in this area has found that it is not possible to delineate barriers to accessing treatment for eating disorders from barriers to accessing mental health support – they are intertwined in a complex relationship featuring stigma, the fear of social ostracism, race, culture, self-esteem, body image, food, and family dynamics. Unless clinicians working in the eating disorders space recognise these factors and actively engage in learning about their impacts, their work will never truly speak to the clients who need it the most.