Eating Disorders Don't Discriminate - Do They?

This blog is part of a special 12-month series titled, “Inclusive Eating Disorder Recovery: How Yoga Therapy Can Help” written for Yoga for Eating Disorders. Through my blogs and related social media posts, I will explore how we can use the ethics of Yoga, personal practice, movement, breath, focused attention, and meditation to create recovery spaces that are inclusive and reflective of diverse lived experience. Join in the conversation on Instagram by following along @yogaforeatingdisorders and @holisticyogatherapist.

Dis·crim·i·nate (verb): make an unjust or prejudicial distinction in the treatment of different categories of people, especially on the grounds of race, sex, age, or disability.

Ongoing conversations about the impacts of racism and white supremacy generally, and in healing practices, have deepened our understanding of how these perspectives influence the systems and structures that govern our lives. One benefit of the increase in awareness is the shift in our understanding of who experiences eating disorders. This shift has come with broader representation and media depictions no longer center young, white, female appearing people with privilege as the poster children for eating disorders.

 As our collective comprehension shifts, you see the line “eating disorders don’t discriminate” in articles and blog posts along with visuals that include people with different identity markers appearing more frequently. While the statement is true, this increase in representation is not the same as inclusion.

 As we are coming to learn, acknowledging and depicting more gender, socioeconomic, racial and sexuality diversity is a good first step to raise awareness of how prevalent eating disorders are. But we cannot stop there, or we risk further marginalizing, tokenizing, and harming communities - which is the opposite of the first yama or ethical principle in the Yoga Sutra - ahimsa or doing no harm.

 How can yoga, beyond the mindful movement practice, help us address eating disorders in a truly inclusive way? The practice of yoga is about being connected and in relationship with each other and the universe. The yamas or ethical principles provide guidelines that support this inclusive practice.

 A truer realization of ahimsa is including people with intersectional identities and their communities in information gathering, care, and support. We could start by taking the statement “nothing about us without us”, to heart and working to remove systemic and structural barriers rooted in institutional practices, policies, traditions and/or values that limit access and have serious and long-lasting impacts on the lives of those affected.

It also includes personal reflection and understanding of how our internalized bias shapes our relationships to people, and to the systems and structures we maintain. This deliberate self-study will help ensure that we do more than invite people to the table, but that we build it with them to limit future harm.

This thoughtful, deliberate practice of inclusion would benefit from the integration of another yama, satya or truthfulness which is relevant to research and data collection. The lack of available data about eating disorders in traditionally underrepresented communities results in policies, procedures and decisions being made without an awareness of the full truth of the current state.

This stems from a lack of inclusion of individuals from underrepresented communities in research and academic spaces. A 2018 report published by the Canadian Association of University Teachers, Underrepresented and Underpaid: Diversity & Equity Among Canada’s Postsecondary Education Teachers, highlights the persistent lack of diversity in the academic workforce, and wage gaps between men and women, and between white and Indigenous and racialized staff.[1]

 A lack of researchers who are curious about what is happening in their communities can contribute to a lack of nuanced exploration and resulting data. Gathering and examining this data is important because it informs individual perspectives as well as institutional systems and structures - that otherwise discriminate, even if eating disorders do not.

 The Information that we do have from the National Eating Disorders Association indicates:

• rates of disordered eating have increased across all demographic sectors, but at a faster rate in male, lower socioeconomic, and older participants.[2]

• Despite similar rates of eating disorders among non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, people of color are significantly less likely to receive help for their eating issues.[3]

• Males represent 25% of individuals with anorexia nervosa, and they are at a higher risk of dying, in part because they are often diagnosed later since many people assume males don’t have eating disorders.[4]

• In a survey of college students, transgender students were significantly more likely than members of any other group to report an eating disorder diagnosis in the past year.[5]

Collecting and examining data from underrepresented communities will help us better understand how the intersectionalities of identity markers shape individual and community relationships with food, body image, and shed light on what culturally appropriate support looks like. Care providers who lean into the yama of asteya or responsibility might benefit from exploring how this information shapes how they see care seekers. Care seekers and those who support them would also benefit since their increased awareness may support more effective advocacy and access to care.

This awareness of internal bias is important since information from the National Eating Disorders Association indicates that when presented with identical case studies demonstrating disordered eating symptoms in white, Hispanic and African-American women, clinicians were asked to identify if the woman’s eating behavior was problematic. 44% identified the white woman’s behavior as problematic; 41% identified the Hispanic woman’s behavior as problematic, and only 17% identified the black woman’s behavior as problematic. The clinicians were also less likely to recommend that the African-American woman should receive professional help.[6]

Another yama that has value when working towards inclusion is bhramacharya or the deliberate use of your energy to find unity with the universe. This includes making the choice to deepen your personal and collective understanding and develop a thoughtful, nuanced approach that takes the complexity of intersectionality and identity markers into account. While it might seem counterintuitive to examine markers of identity that are used as ways to differentiate us from each other, learning more about the experiences of people who have them will help highlight similarities within the experience that are rooted in our shared cosmic energy.

The last yama on the list is aparigraha or generosity, which can be interpreted as the act of deliberately making space and working within our individual beliefs and systems to include underrepresented people and communities. If you are a researcher in this space, how can you deliberately make your research more inclusive? What could you do to engage with traditionally underrepresented colleagues, or change how you work with communities?

If you are a care provider, aparigraha or generosity might manifest as a deep personal exploration to develop a practice that is more culturally appropriate and responsive. It may also look like generously sharing your learnings and resources with other care providers to model how it can be done and encourage them to do something similar.

If you are seeking care for yourself, or someone else, your practice of aparigraha or generosity might be a personal exploration of how you can safely challenge stereotypes while seeking care. It may be acts of advocacy - whether that is sharing information with care providers or participating in research to help build an evidence base.

If you are already acting on these yamas to address discrimination, we would love to learn more about what you are up to. Please share how it is going so far, what has worked well, and what you might set aside. Tell us in the comments, or message us on instagram at https://www.instagram.com/holisticyogatherapist/ and https://www.instagram.com/yogaforeatingdisorders/

Resources to Support Your Exploration

Marginalized voices project

Canadian Research Projects

Colour Blindness and ED

Ethnic Discrimination and Weight Outcomes

Racism and ED