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How Black People are Underrepresented in Eating Disorder and Treatment

How Black People are Underrepresented in Eating Disorder and Treatment

Written By: Taylor Hutchinson, BS

Eating disorders have long been seen as a disease that only affects young white women. Whether through research or marketing, this group of individuals often appears as the face of this disorder. Few studies have been conducted on how eating disorders affect the black community. However, what we do know is that black individuals are far more likely than their white counterparts to have bulimia (over 50% to be exact) or present with binge eating disorder symptoms. However, research also shows that they are less likely to be diagnosed, receive treatment, or have this even discussed with them by their doctors. Eating disorders in non-white individuals often present differently, though since doctors continue to measure the symptoms through a euro-centric viewpoint this leads to underdiagnosis. As an eating disorder treatment facility, it’s important for us to continue education and training on how this disease affects individuals from all varying cultures and backgrounds. This will allow us to break down barriers including stigmas (ie: the perception that eating disorders are a “white woman’s disease”) and access to resources. It will also allow us to increase our cultural competency and serve a much-needed community of individuals who are suffering.

If you or a loved one is suffering from an eating disorder, please know that you are not alone. We see you and we will be here for you every step of the way. Take the first step today and learn more about the eating disorder treatment programs that we offer.

Additional readings:

Tea Party Exposure at Prosperity

Prosperity Tea Party

By: Kelly Wilson, BS, BA, DTR, Nutrition Tech

Here at Prosperity we provide a variety of services to our clients, including multiple types of therapy and nutrition interventions. The clients participate in group and individual sessions with their team of providers, but typically the most difficult work is done at the dining room tables. Exposure is a tool we use often in treating eating disorders due to its proven benefits in the client’s recovery journey (2018). The American Psychological Association defines exposure therapy as a psychological treatment developed by therapists to help people confront their fears and anxiety by breaking the pattern of fear and avoidance (2017). Types of nutrition-related exposures provided at prosperity include a weekly challenge snack, inning meals from restaurants and more. We also include the occasional special exposure like what we did for our Holiday challenge meal this year.

This holiday season we organized a tea party themed meal for our clients. We served an array of finger foods that were placed on serving platters on the table along with a sparkling cider and sherbert drink. The clients were encouraged to grab food from the middle of the table to build their own meal in the moment with the support of our staff. This type of “party appetizer” or “finger food” meal building can be triggering for our clients which is why we arranged to do this exposure in a controlled and supportive environment. Exposing clients to this experience allowed them to practice self-portioning at the table and encouraged them to break the pattern of avoidance (Yetman & Saripalli, 2021). In PHP at Prosperity clients participate in a weekly “build your own” lunch where they plate and portion their own meals. For example, in the past we have had clients build their own taco bowls, salads, loaded baked potatoes and more. What made this tea party themed meal different was having the clients serve themselves at the dining table as opposed to a “buffet style” set up where they build their plates one at a time with the assistance of nutrition staff. All the food-related exposures that we do at Prosperity have the same goal; to create realistic beliefs about the fears that clients have around certain foods and situations while making sure that they feel safe and supported.

At Prosperity any chance to do something special for our clients is exciting to us. We strive to provide an environment for clients to work on recovery but also enjoy coming into everyday. While eating disorder treatment can be challenging we hope that our expert staff and compassionate treatment will guide clients on their journey to full recovery.

American Psychological Association. (2017, January). What is exposure therapy? American Psychological Association. Retrieved December 30, 2022, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy

Yetman, D. (2021, June 21). Exposure therapy: Types, how it’s done, and more. Healthline. Retrieved December 30, 2022, from https://www.healthline.com/health/exposure-therapy

What to expect from treatment. National Eating Disorders Association. (2018, August 3). Retrieved December 30, 2022, from https://www.nationaleatingdisorders.org/what-expect-treatment

Virginia’s Premier Day Treatment And Intensive Outpatient Treatment Centers

Prosperity Eating Disorders & Wellness Center specializes in the treatment of eating disorders while offering evidence-based, comprehensive, ethical, and individualized treatment to all ages, ethnicities, genders, and eating disorders. Our goal is to help sufferers find a full recovery by meeting their psychological, nutritional, emotional, and relational needs. We specialize in treating Anorexia, Bulimia, EDNOS, Orthorexia, and Binge Eating Disorder. With locations in Herndon and Norfolk, Prosperity is equipped to serve the needs of adolescents and adults throughout Virginia. 

Get started with Prosperity Eating Disorders & Wellness Center today!

Can Your Doctor’s Office Trigger Bad Body Image?

Can Your Doctor’s Office Trigger Bad Body Image?

Can Your Doctor’s Office Trigger Bad Body Image?

Sometimes I get tired of all the subtle ways women are told they’re not good enough. I’ve gotten used to it happening in magazines, commercials, and in all the ads that tell us how to look younger, prettier, sexier, and skinnier. So I expect to see those messages in certain settings, which I can mostly avoid.
I just never expected to see that in my OB-GYN’s office.
Today when I walked in, (after a nice long Covid hiatus of which length we won’t mention) I was greeted with not one, but two full-sized standing banners advertising liposuction and laser therapy. Literally flanking the front of the check-in counter, with a whole table of anti-aging skin products laid out in between. With “You deserve to feel like yourself again!” slogans next to life-size pictures of smiling, women without wrinkles or cellulite anywhere. So, as I walked up to check in for my appointment (where I planned to discuss the various fun things one might discuss when she’s 48 and has had 3 kids, etc etc) I had to reach across all of this in order to check in with the receptionist! Even in the bathroom, there were more ads up with before and after pictures advertising wrinkle removal- right up next to that cute little silver cupboard where you deposit your urine sample. These were also spread out in my patient room. Really?!
I guess things had changed in the practice during those years when I was away.
One might say that I’m just a cranky middle-aged woman that’s having a hard time getting older and is taking this too personally. That’s actually not the case at all. My 40’s have been a pretty incredible decade of learning to love myself with all of my imperfections, and I feel more beautiful now than I did back in my 20’s- even with all my gray hairs and wrinkles. I also have nothing against the beauty product or cosmetic surgery industries, as they can be sources of wonderful help and healing for people of all genders. I just think there’s a time and a place for this kind of advertising, and it’s not the kind of thing I’d expect or want to see at my OB’s or any other of my doctors at any age.
– not when I went in expecting to hear my first baby’s heartbeat and heard… nothing
– not when I went in for a post-D&C appointment after my miscarriage
– not when I was pregnant with my firstborn.
– not when I had my first breast exam after a lumpectomy
Not for a whole host of other reasons that so many women have to navigate and work through when they come in for their OB appointments for less than happy reasons.
For those of you still reading, thanks for staying with me through this rant.
And if you just so happen to have the name of a great OB practice in NOVA, go ahead and pass that my way.

Shannon Wise

When I read my friend Shannon’s post, I knew I needed to address this with the community. There’s just so much to unpack here.

In my years of seeing and treating hundreds of teens and adults struggling with eating disorders, poor body image, and shame, after a while, I begin to see a few trends along the way.

In no particular order, below are the triggers that are typically expressed by clients that have led to their eating disorders
1. Bullying
2. Severe dieting
3. Caregivers that diet, hyper-focus on eating overly healthy, and being thin.
4. Comments made by pediatricians and other physicians
5. Advertising and Social Media
6. Depression and Anxiety

Yes, you read that right, comments made by doctors. For a field that’s supposed to “first do no harm”, why is it that we’re seeing them on this list? Physicians ONLY need to take 1-1.5 credits focused on eating disorders during their studies. While it’s great that they can identify and diagnose an eating disorder, shouldn’t prevention and treatment be some of the focus? So often doctors suggest weight loss programs, tell patients they are overweight, that the cause of their illness is weight related, and praise them when they come back in a smaller body. This praise and the need to lose weight to be taken seriously can ultimately lead to one of the deadliest mental health disorders facing people. So when and how do we start expecting more from our providers? When do we start to hold them accountable and open their eyes to the microaggressions found in their offices? When will fat phobia and bias be left at the door and physicians start treating the person as a whole? Because right now, just telling people to lose weight isn’t helpful, it’s harmful.

About a year ago, one of my employees went to a gastroenterologist due to ongoing stomach pain, cramping, and heartburn. After coming out of anesthesia due to getting an endoscopy, the doctor’s only suggestion was……………you guessed it weight loss. This normally happy woman left the office that day and relayed the story to us in tears and looking defeated. She felt ashamed, embarrassed, and self-conscious, and still had no answers as to how to fix this problem.

Now I have lost count of how many of my clients have described when they first started to have eating disordered thoughts, that one of the causes of them was the way their pediatrician commented on their body size, and each time these clients quoted their doctors told them “you’re overweight”. If a patient continues to hear that from someone who they believe to be an expert in health, it’s not too hard to expect the patient will begin to think of themselves in a negative light. “I’m not good enough”, “Something’s wrong with me”, “I’m clearly doing something bad and wrong”. This narrative needs to change, help not hinder.

So lo and behold – I went to my OBGYN for my yearly appointments last week and opening the entrance to the waiting room my stomach dropped to my ankles. I was flooded by the images that Shannon described. Ads to look better by getting liposuction and more.

As I teach my clients how to advocate for their needs and rights, how to see themselves with neutrality and with loving kindness, and to reject the need to conform to the  – I must do so myself and I hope you do too.  The doctor at my practice helped deliver my baby 16 years ago. She is a wonderful doctor. But I can NEVER refer to this practice to any of my clients or any person for that matter.

Have you had similar experiences? Did this affect your body image?

I know I am going to hear from my colleagues that I shouldn’t post these pictures,  as they are triggering. Yes. I know.  Exactly.

None of us are spared from this reality and it is everywhere we go.

Will you join me in allowing yourself to take up space in this world and use your voice?

Heather Baker, LCSW, CEDS
Founder of Prosperity Eating Disorders and Wellness
www.prosperityedwell.com

Prosperity Advocates for Critical Eating Disorder Treatment Legislation

Prosperity Advocates for Critical Eating Disorder Treatment Legislation

Prosperity Eating Disorders and Wellness Center meets with Quena Dailey, Constituent Services Representative of US Senator, Tim Kaine

Prosperity Eating Disorders and Wellness Center had the greatest pleasure and opportunity to meet with Quena Dailey, MPhil, MPA. Quena Dailey is the Constituent Services Representative at the office of United States Senator, Tim Kaine.

Quena Dailey was given a tour of our eating disorder treatment facility in Norfolk, Virginia, as we told her more about who we are, what are doing for our community, and discussed particular issues around insurance coverage for eating disorders. We sat down and discussed the two bills we are working towards getting passed that will make a more significant change in the healthcare and eating disorder community. These bills include the Telemental Healthcare Access Act and the Anna Westin Legacy Act.

The Telemental Healthcare Access Act:

• The bill removes the statutory requirement that Medicare patients be seen in person within 6 months of being treated for mental health services via telehealth.
• This bill is consistent with how SUD telehealth services are covered under Medicare.

• Given commercial payors rely heavily on Medicare to make coverage determinations, we want to ensure these artificial barriers are not replicated in other insurance markets.

The Anna Westin Legacy Act:


• This bill would reauthorize the Center of Excellence for Eating Disorders to continue training primary and allied health professionals to screen, briefly intervene, and refer individuals with eating disorders.

• The bill would expand the evidence-based SBIRT protocol to the pediatric level.

• It would also build adaptive modules for at-risk communities that experience under-identification, including racially diverse and tribal communities, rural communities, men and boys, military families, veterans, and LGBTQ populations.

Prosperity Eating Disorders and Wellness Center would love to thank Quena Dailey for representing US Senator, Tim Kaine, for taking the time to tour our facility, learning more about who we are and what we do as well as listening to the changes that we are so passionate in working towards for our community!

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