Who We Forget When We Talk About Eating Disorders
TW: eating disorders, identity-based discrimination
The Myth
When you hear "eating disorder," what image pops into your mind? If it's a young, thin, white woman meticulously dissecting a salad leaf by leaf, you're not alone. This stereotype pops up everywhere—in TV shows, magazine articles, and even well-meaning awareness campaigns. And while it may represent some people with eating disorders, it leaves so many others invisible.
Worse, this narrow portrayal isn’t just inaccurate—it’s actively harmful. For many years, I simply did not understand the severity of my own disordered behaviors because I was never in a small body. These stereotypes silence countless voices, delay care, and keep us from addressing eating disorders as the complex, far-reaching issues they really are.
So, where does that leave the people who don’t fit the narrow stereotype? Let’s talk about the real picture.
The Reality: Eating Disorders Don’t Discriminate
Eating disorders (EDs) affect individuals across all races, genders, ages, body sizes, and beyond. Clinging to outdated stereotypes not only misrepresents the issue but also prevents many from seeking or receiving the help they need.
Historically, ED and disordered eating behavior research has stuck to a very narrow script: white, cisgender women—largely because that is the subgroup of people who are diagnosed and seek treatment. This type of skewed research has a snowball effect into the medical and mental health world, where providers are not as well equipped to serve populations that are less studied and published about.
It’s important to understand the myriad of populations that are impacted by EDs, so that everyone who has to navigate this issue are given proper consideration, care, and support. Below is an abridged list and very cursory overview that can help challenge our thinking and biases (citations included at the end of this article):
BIPOC Community: Research has repeatedly found the same or similar occurrence of EDs among Black, Latinx/Hispanic, Asian, and Native American communities in comparison to white peers. However, there are barriers to diagnosis and treatment because of (and not limited to): stigma around mental health, quality healthcare inequity, societal expectations and stereotypes, and limited access to culturally competent care.
Men: Approximately 25% of individuals with anorexia nervosa are male. Due to the misconception that eating disorders are "female issues," men often face delayed diagnoses, resulting in higher mortality rates.
Older Adults: Eating disorders are not confined to adolescence. Adults over 30, 40, and beyond can develop these conditions, often triggered by significant life changes or stressors like childbirth, divorce, menopause, grief, etc. Yet, they frequently go unrecognized in this demographic.
People with Disabilities (physical & neurodivergence): While this community is incredibly diverse, some portions of the community are disproportionately impacted by EDs. For example, up to 20% of people in ED treatment are autistic (due to behavior overlap such as strict adherence to rules). There is also a dearth of providers who understand both disability and disordered eating,
LGB+ Individuals: Gay & bisexual men are more likely to experience EDs compared to straight peers because of cultural emphases on achieving a certain physique. Statistics on lesbian & bisexual women are inconsistent, however studies show elevated or same prevalence of EDs as straight women. This may be impacted by pressures on women from society overall, but also expectations from within the community around idealized body types.
Transgender Community: Research on transgender, and especially non-binary, individuals is in its early stages. Existing studies have shown higher prevalence of EDs within the trans community, especially among youth. On a very important note, EDs decrease for those who obtain gender affirming care - which supports the theory that EDs are (in-part) related to the desire to physically obtain attributes aligning with their gender identity.
Larger-Bodied Individuals: Eating disorders don't have a specific body size. Individuals in larger bodies can and do suffer from conditions like anorexia (called atypical anorexia) and bulimia at comparable rates, with similar health outcomes. Unfortunately, their symptoms are often overlooked or dismissed as mere dieting, delaying critical treatment.
A note on intersectionality:
“[Intersectionality is] a lens, a prism, for seeing the way in which various forms of inequality often operate together and exacerbate each other. We tend to talk about race inequality as separate from inequality based on gender, class, sexuality, or immigrant status. What’s often missing is how some people are subject to all of these, and the experience is not just the sum of its parts.” - Kimberlé Crenshaw
It’s vital to consider that people that exist across several overlooked identities are even less researched and understood - I, for example, was not able to find a single published piece of research on EDs in disabled, Black, transgender men. People have layered and distinct experiences that lead to more exacerbated instances of subpar resources, social stigma, and lack of medical access and care.
Orthorexia: Overlooked By a Health-Obsessed Society
Since we are on the topic of overlooked identities, I will also mentioned overlooked behaviors. In our wellness-obsessed culture, striving to eat healthily is common. But for some, this focus can become an unhealthy obsession known as orthorexia nervosa (not yet categorized in the DSM, but gaining more attention from the medical community). We’ve all seen it—people meticulously avoiding certain ‘dirty’ ingredients, or anything they deem even slightly ‘processed’.
For some, it’s a lifestyle choice that has no impact on their wellbeing. For others, this obsession can spiral into orthorexia, where the pursuit of 'clean eating' takes over their lives. Unlike other eating disorders that focus on quantity, orthorexia is characterized by an obsession with food quality and purity. Individuals may eliminate entire food groups they deem "impure," leading to nutritional deficiencies and social isolation. I will dedicate posts to orthorexia in the future.
The Danger of a Single Story
Power structures and stereotypes shape how people live—and often limit their access to care and support. Perpetuating the stereotype that eating disorders and disordered eating behaviors only affect a specific group or look a certain way creates significant barriers including under-diagnosis, inappropriate or insufficient care, stigma, shame, and lack of overall resources.
Breaking these stereotypes isn’t just about better care—it’s about ensuring everyone feels seen, supported, and worthy of healing. No matter what identities we fall into, we all deserve a life of liberation from disordered eating and the pursuit of obtaining what society deems an ideal or acceptable body. Together, we can push for a broader, more inclusive understanding of what it means to live free from disordered eating.
Cited Sources:
Austin, S. Bryn, et al. “Eating Disorder Symptoms and Obesity at the Intersections of Gender, Ethnicity, and Sexual Orientation in US High School Students.” American Journal of Public Health, vol. 103, no. 2, Feb. 2013, pp. e16–e22, www.ncbi.nlm.nih.gov/pmc/articles/PMC3558764/, https://doi.org/10.2105/ajph.2012.301150.
Cheng, Zhen Hadassah, et al. “Ethnic Differences in Eating Disorder Prevalence, Risk Factors, and Predictive Effects of Risk Factors among Young Women.” Eating Behaviors, vol. 32, Jan. 2019, pp. 23–30, https://doi.org/10.1016/j.eatbeh.2018.11.004.
Corbett, Sophie. “Eating Disorders in the LGBTQ+ Community - Mental Health Dietitians.” Mental Health Dietitians, 12 June 2024, www.mentalhealthdietitians.com/eating-disorders-in-the-lgbtq-community/?utm_source=chatgpt.com. Accessed 12 Dec. 2024.
Diemer, Elizabeth W., et al. “Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students.” Journal of Adolescent Health, vol. 57, no. 2, Aug. 2015, pp. 144–149, www.ncbi.nlm.nih.gov/pmc/articles/PMC4545276/, https://doi.org/10.1016/j.jadohealth.2015.03.003.
Egbert, A.H. et al. (2022) Reporting racial and ethnic diversity in eating disorder research over the past 20 years. The International journal of eating disorders. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11389655/ (Accessed: 11 December 2024).
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