Eating Disorder Advocacy & Treatment
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Accessing Eating Disorder Treatment
Accessing eating disorder treatment is challenging due to systemic, economic, and cultural barriers. There is a shortage of specialized providers, fragmented care systems, and limited insurance coverage, especially for intensive or long-term treatment.
Diagnostic criteria often rely on narrow, weight-based thresholds that exclude many who need help, particularly those in larger bodies, people of color, LGBTQ+ individuals, and men.
Stigma, cultural misconceptions, and a lack of inclusive, trauma-informed, or harm-reduction approaches further deter access. Additionally, treatment can be prohibitively expensive, geographically inaccessible, or psychologically unsafe for those with prior invalidating experiences.
Addressing these barriers requires systemic reform, intersectional training, and more flexible, community-based models of care.
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Equitable Eating Disorder Treatment
Equitable eating disorder treatment is inclusive, accessible, and grounded in social justice, centering the diverse identities and lived experiences of all individuals, not just those who fit narrow stereotypes.
It rejects weight-centric models and BMI-based gatekeeping, affirming body diversity and addressing weight stigma, fatphobia, and healthism directly.
Culturally responsive care honors diverse foodways and acknowledges the impact of racism, colonialism, and intergenerational trauma, while LGBTQIA+ affirming treatment recognizes the unique needs of queer and trans individuals, including the role of gender-based trauma and body surveillance.
Trauma-informed and harm-reduction approaches respect autonomy, avoid rigid recovery expectations, and validate the ways disordered eating can function as a survival strategy.
Equitable treatment is also financially and geographically accessible, offering telehealth, community-based care, and integration into primary and mental health services.
Finally, it values peer support and lived experience, recognizing healing as not just symptom reduction, but the reclamation of body trust, food freedom, and belonging.
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The Truth Behind Eating Disorder Treatment Access
Despite growing awareness, the system remains deeply inequitable, under-resourced, and shaped by stigma and exclusion.
Most people with eating disorders, especially those in larger bodies, BIPOC, LGBTQIA+ individuals, and those with limited financial means, face major barriers to care.
Access is often determined not by need, but by insurance coverage, BMI, location, and whether a person fits a narrow stereotype of who is “sick enough” to deserve help.
Many treatment programs remain rooted in weight-centric, abstinence-based models that do not accommodate harm-reduction, trauma-informed, or culturally relevant approaches.
Care is often prohibitively expensive and geographically inaccessible, especially in rural or underserved areas. Moreover, those who do access treatment frequently encounter invalidating or pathologizing experiences that ignore their identities and lived realities.
The truth is, we need a radical reimagining of eating disorder care one that centers equity, bodily autonomy, and community, and that dismantles the structural and ideological barriers that keep so many people from receiving the support they deserve.
Eating Disorders in the LGBTQ+ Community
Eating disorders disproportionately affect LGBTQ+ individuals due to a combination of minority stress, discrimination, body image pressures, and trauma. Research consistently shows that LGBTQ+ people, particularly transgender and nonbinary individuals, experience higher rates of disordered eating compared to their cisgender heterosexual peers (Diemer et al., 2015). These disparities are driven in part by stigma, societal rejection, and internalized oppression, which can manifest in maladaptive coping strategies such as food restriction, binge eating, or body manipulation (Watson et al., 2017). Furthermore, mainstream eating disorder treatment often fails to affirm LGBTQ+ identities, leading to underdiagnosis, misdiagnosis, or disengagement from care. Affirming, intersectional, and trauma-informed approaches are essential for addressing these inequities and ensuring that LGBTQ+ individuals receive competent and culturally responsive support.
References
Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D. A., & Duncan, A. E. (2015). Gender identity, sexual orientation, and eating-related pathology in a national sample of college students. Journal of Adolescent Health, 57(2), 144–149. https://doi.org/10.1016/j.jadohealth.2015.03.003
Watson, R. J., Veale, J. F., & Saewyc, E. M. (2017). Disordered eating behaviors among transgender youth: Probability profiles from risk and protective factors. International Journal of Eating Disorders, 50(5), 515–522. https://doi.org/10.1002/eat.22627
Eating Disorder In The Fat Community
Individuals in the fat community face elevated risks for eating disorders, often driven by weight stigma, discrimination, and systemic anti-fat bias in healthcare and society. Contrary to the stereotype that eating disorders only affect thin individuals, research indicates that people in larger bodies may engage in significant disordered eating behaviors such as chronic dieting, restriction, or binge eating often overlooked or even encouraged by providers under the guise of "health" (Hunger et al., 2020). Fat individuals are less likely to be diagnosed or referred for treatment, and when they are, they frequently encounter weight-centric care models that pathologize their bodies rather than support recovery (Tylka et al., 2014). This marginalization can result in underdiagnosis, inadequate care, and treatment-related harm. Equitable eating disorder care must reject weight-based diagnostic thresholds and affirm body diversity to effectively support the fat community in healing.
References
Hunger, J. M., Smith, J. P., Tomiyama, A. J., & Crandall, C. S. (2020). Weight stigma and health behaviors: Evidence from the eating disorder literature. Current Obesity Reports, 9(2), 168–175. https://doi.org/10.1007/s13679-020-00378-2
Tylka, T. L., Annunziato, R. A., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C., & Calogero, R. M. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014, Article 983495. https://doi.org/10.1155/2014/983495
Eating Disorders in the Disability Community
Eating disorders in the disability community are under-recognized and under-researched, despite evidence that disabled individuals may be at heightened risk due to complex intersections of ableism, body surveillance, trauma, and medical marginalization. Disabled people often experience greater pressure to conform to normative body ideals or to “overcome” disability through appearance and performance, which can lead to disordered eating as a means of asserting control or social acceptance (Klein & Forber-Pratt, 2020). Additionally, healthcare providers may overlook or misattribute eating disorder symptoms to a person’s disability, resulting in delayed or denied treatment (Kerschke-Risch, 2015). Many treatment models are not accessible or inclusive, failing to accommodate mobility needs, sensory processing differences, neurodivergence, or communication styles, which contributes to systemic exclusion. To address these disparities, eating disorder treatment must be physically, attitudinally, and structurally accessible, and rooted in disability justice and anti-ableist frameworks.
References
Kerschke-Risch, P. (2015). Eating disorders and disability: An explorative study on the specific life situation and needs of women with disabilities. Disability & Society, 30(7), 1021–1036. https://doi.org/10.1080/09687599.2015.1075866
Klein, K. M., & Forber-Pratt, A. J. (2020). Disability identity development and eating disorders: An intersectional analysis. Journal of Social Issues, 76(2), 407–424. https://doi.org/10.1111/josi.12388