Breaking Down Barriers to Eating Disorder Care
Accessing care for eating disorders involves navigating barriers that stand in the way of individuals seeking help, receiving appropriate treatment, or fully engaging in their recovery process. Breaking down these barriers begins with deconstructing stigmas, spreading awareness and education, and increasing treatment access.
This HEAL Week, we wish to spotlight the barriers to care and have critical conversations that often go unshared. Everybody deserves recovery, and no one should have to fight for their treatment.
How can we collectively help to bring access and equality to eating disorder care?
1. Recognizing and deconstructing stigma
The stigma surrounding eating disorders contributes to a significant barrier to care, as it may discourage individuals from seeking help, impact our ability to spot warning signs, and decrease the likelihood of necessary medical intervention. Race, gender, identity, and body size are only a few factors that often increase stigma and decrease access to care.
Race
For example, research shows that BIPOC individuals who are struggling with eating disorders are less likely than non-minority individuals to be asked about potential eating disorder symptoms by medical professionals (Source 1). Although the rate of eating disorders does not change when compared to white people, BIPOC individuals are half as likely to receive a diagnosis, and Latinx clients were half as likely to receive treatment (Source 2).
Gender
Lapses in eating disorder care are also found across clients of different genders and sexualities. Men struggling with eating disorders are less likely than women to take their symptoms seriously, which in turn leads to their eating disorders often being more severe by the time medical care is sought out (Source 3). Even when men do seek care, there is an increased likelihood that they will be denied the treatment that a woman would be more readily offered (Source 4). Healthcare professionals are actively minimizing and overlooking symptoms of eating disorders in men, while women are up to five times more likely to receive a diagnosis that may lead to lifesaving care (Source 5).
Sexuality
LGBTQIA+ individuals also experience a high likelihood of discrimination, harassment, mistreatment, and denial of mental health care services, as compared to the general population (Source 6). 18% of 300,000 transgender college students surveyed report that they had an eating disorder within the previous year, while 74.8% of these transgender students had also attempted suicide within the same year (Source 7).
Body Size
Body size is another key factor in recognition of eating disorders. Those struggling with atypical anorexia nervosa are less likely to receive treatment than those diagnosed with anorexia (Source 8). Weight stigma is a serious concern when it comes to barriers to care, as the majority of clients struggling with weight stigma end up not seeking healthcare when health issues arise (Source 9).
Athletes
We are also seeing stigma toward athletes, as they are often held to specific standards and expectations and therefore often hit roadblocks when seeking treatment for eating disorders. This can be further impacted by an athlete’s sport, as certain sports have more of an emphasis on body composition and aesthetic (Source 10).
2. Advocating through awareness and education
Learn about eating disorders.
Continuing the white, thin, affluent woman eating disorder stereotype does a great disservice to the overwhelming amount of people who don’t fall into those categories. Everyone deserves treatment, regardless of who they are or what they look like. Taking steps to raise awareness and increase education about eating disorders is important in dismantling exclusionary beliefs and assumptions about those who may have an eating disorder. Understanding eating disorders goes hand in hand with decreasing the stigma that often serves as a barrier between someone struggling and lifesaving treatment.
Share your story.
We know that eating disorders are on the rise and have the second highest mortality rate of any mental illness (Source 11). Efforts to educate others are vital to increasing access to care. If you are living with an eating disorder, sharing your firsthand knowledge with others may provide a valuable perspective and learning opportunity. If you are comfortable doing so, advocate for mental health and eating disorder awareness at your school or workplace to make both yourself and your peers feel understood and welcomed.
If you don’t have lived experience with an eating disorder, there are many ways to seek out information, whether through reputable news sources and social media accounts or starting conversations with those around you. Awareness and education are key, and even small differences can contribute to an environment that breaks down social and societal barriers to access care.
3. Increasing accessibility and availability
Even if an individual overcomes societal, social, or personal barriers and decides to seek help, they may struggle with accessibility and availability of treatment. Unfortunately, this shows up in many forms, including financial barriers, geographic limitations, and lack of provider availability, to name only a few.
Insurance as a Financial Barrier
Although many options for treatment may accept insurance, that doesn’t guarantee affordable coverage. This problem spans across all levels of care, from outpatient to inpatient treatment. For example, in a study of adolescents ages 11 to 25 who were suffering malnutrition from an eating disorder, only 40% received the recommended treatment, and patients who used public insurance were only one-third as likely to receive the recommended mental health treatment for their eating disorders as youth with private insurance (Source 12). This potential financial burden can pose as a deterrent, making treatment inaccessible.
Geographic Barriers in Treatment Deserts
Despite the increasing amount of virtual outpatient options, there are still geographical regions that may be underserved, often referred to as treatment deserts. Although it is possible for some individuals to travel out of state to receive a higher level of care, this is not a privilege that is realistic for everyone. Also, provider shortages impact treatment availability, which can lead to long waits for appointments and varied quality of care.
Thank you to those who are breaking down barriers
We express our appreciation to the mental health professionals nationwide for their invaluable support and unwavering compassion. Their dedication plays a critical role in saving lives and improving the quality of care for individuals struggling with eating disorders.
Understanding the complexities of eating disorders is crucial, as they involve a range of psychological, emotional, and physical difficulties. It is essential to foster environments where individuals feel secure and supported in seeking help. Creating these environments involves addressing the barriers that prevent access to effective care.
While overcoming these barriers presents significant challenges, it is an imperative step toward establishing a mental health care system that ensures more people receive the help they need. By working together to increase access and support, we can create a more inclusive and effective approach to treating eating disorders and supporting individuals on the road to recovery.
A message to those who are struggling
Struggling with an eating disorder is difficult enough, without having to face the barriers that stand between you and the help that you deserve. If you are experiencing obstacles while looking for treatment, Project HEAL may be able to help, as they continue their goal of providing life-saving support for those with eating disorders while working on changing the mental health care system.
If you or a loved one are looking for eating disorder treatment, Monte Nido is here for you. With in-person programs in 14 states and virtual programs in 28 states, our team provides the outcomes-backed treatment that leads to long term recovery.
Sources:
(Becker, A. E., Franko, D. L., Speck, A., & Herzog, D. B.)
(Becker, A. E., Franko, D. L., Speck, A., & Herzog, D. B., Moreno, R., Buckelew, S. M., Accurso, E. C., & Raymond-Flesch, M.)
(Räisänen, U., & Hunt, K.)
(Andersen, A.E.)
(Richardson, C., & Paslakis, G., Sonneville, K. R., & Lipson, S. K.)
(Center for American Progress. Report: Discrimination and Barriers to Well-Being: The State of the LGBTQI+ Community in 2022).
Duffy, M.E., Henkel, K.E. and Joiner, T.E. (2019). Prevalence of Self-Injurious Thoughts and Behaviors in Transgender Individuals With Eating Disorders: A National Study. Journal of Adolescent Health, 64(4), pp.461–466.
Moreno, R., Buckelew, S. M., Accurso, E. C., & Raymond-Flesch, M.
Puhl, R. M., Lessard, L. M., Himmelstein, M. S., & Foster, G. D.).
(Flatt, R., Thornton, L., Fitzsimmons‐Craft, E., Balantekin, K., Smolar, L., Mysko, C., Wilfley, D. E., Taylor, C. B., DeFreese, J. D., Bardone‐Cone, A. M., & Bulik, C. M)
(STRIPED, Academy for Eating Disorders and Deloitte Access Economics)
(Moreno, R., Buckelew, S. M., Accurso, E. C., & Raymond-Flesch, M.).
