February 21-27, 2022, honors National Eating Disorder Awareness Week. Eating disorders are historically associated with young, heterosexual, cisgender white women, while marginalized communities remain underrepresented in conversations about eating disorders. For example, black teens are 15% more likely to develop symptoms of bulimia than white teens, yet people of color are less likely to be asked about symptoms of eating disorders by doctors. Doctors are also less likely to identify eating disorders in marginalized groups, keeping them from getting life-saving treatment.
If you’re Black American, you don’t have to look that far back in history for reasons to distrust the medical field. From forced sterilizations of Black women in today’s prisons to the Tuskegee experiments on Black men, doctors have lost the trust of many communities of color. The barrier of distrust and socioeconomic obstacles of poverty and racism make it extremely challenging for communities of color to get quality health care.
Unfortunately, many Black Americans with eating disorders suffer in silence because of negligence by doctors and economic and social barriers to treatment. However, things don’t have to be this way. There are several actionable steps that the medical field can take to make sure communities of all races and ethnicities receive the care they need.
First, it is essential to teach about the history of medical racism in medical schools. Many medical students leave medical school unaware of the role that race has played and continues to play in the care of Black Americans. It’s impossible to earn back the trust of communities of color if the medical field doesn’t try to understand how they lost it in the first place. We cannot begin to dismantle racism without understanding how it operates in the medical field.
Hospitals and schools also have to hire more faculty and doctors of color. Hospitals must have people of color in all levels of care. In addition, having more people in leadership roles from communities of color will help dismantle institutional racism at a faster rate.
Health institutions should also hire experts in medical racism. It’s all well and good to hire diversity, equity, and inclusion staff and hire people of color. But, if institutions do not understand how to retain those staff and create working conditions under which they can thrive, it’s all just for show. Diversity is not a public relations, performative ploy. On the contrary, it has to reflect in the institution’s actions.
These steps are critical in getting people of color with eating disorders the care they need. Taking steps to diversify health institutions and dismantle institutional racism will help the medical field expand its definition of what someone with an eating disorder looks like and acts like and help people get life-changing care. Committing to the fight against medical racism will ultimately help more people of color access care and allow people with eating disorders to receive the diagnoses that will lead them to treatment.
There is a stereotype that all dancers have eating disorders in the dance community. While that may not be true, doctors must ask everyone about any symptoms they may have regardless of how they look. Doctors should also watch for signs of eating disorders in all dancers, not just those that fit the stereotypical body type associated with eating disorders.
Friends and family should also look out for symptoms of eating disorders, including:
- Preoccupation with food, counting calories, weight, and dieting
- Withdrawal from usual activities
- Extreme mood swings
- Noticeable fluctuations in weight, both up and down
- Stomach cramps and other gastrointestinal issues
- Sleeping problems
- Dental problems
- Dressing in layers or oversized clothing to hide weight loss
By no means is this an exhaustive list, but if you notice a friend displaying any of these symptoms, it’s essential to encourage them to go to a doctor. It’s also important not to say you think someone has an eating disorder in an accusatory manner or tone, as this makes people more defensive and less willing to listen to what you have to say. Someone with an eating disorder might not even be aware that’s what they’re going through, so it’s important to be sensitive and just talk about the symptoms you’re seeing and suggest they go to a doctor. Doctors can only provide a confirmed diagnosis, so you should stay away from any diagnostic language when talking to a friend. However, simply letting someone know you’ve noticed any of these symptoms can be a good wake-up call, and showing you’re coming from a place of genuine concern rather than a desire to expose your friend’s difficulties can go a long way.
Eating disorders are serious and sometimes life-threatening, so we must encourage someone displaying symptoms to see a doctor as soon as possible. It’s also important to remember that eating disorders look different on different people and not to ignore signs and symptoms just because someone looks like they’re at a healthy weight, or even if they’re overweight. People with eating disorders don’t all look one way, so as dancers and people, we need to stay educated and vigilant to reach out to those who may be struggling. You should prepare for a negative reaction to your support, so you must reiterate that you care and be gentle but firm. Even if someone resists at first, you must be patient and supportive in your efforts to get them the help they need. Let them know you’ll listen nonjudgmentally, that you believe in them, and that you’ll be there when they’re ready.