Every single person with an eating disorder deserves access to eating disorder treatment. Yet, just a fraction of people diagnosed with eating disorders receive treatment.
This is partly because getting a provider to approve treatment is extremely difficult, even with insurance. Furthermore, those with larger bodies or a BMI above the “normal” range are often denied coverage even if they present with similar symptoms and medical complications as those with smaller bodies.
However, insurance is far from the only barrier to eating disorder treatment. There are a variety of systemic, cultural, financial, logistical, personal, and healthcare barriers which primarily affect access to treatment for marginalized and minority populations, even when they are willing.
A primary causation of these barriers is the media-perpetuated stereotype that it’s only thin, affluent, white women. Unfortunately, this stereotype is deeply ingrained in the healthcare system, much to the detriment of those that don’t fit “the brief.”
Let’s look at these barriers to demonstrate how important equitable eating disorder treatment is, as well as the work Project Heal does to help break down these barriers.
Recent research estimates that only 10% of people in the U.S. diagnosed with an eating disorder will ever receive treatment2—a number that is considerably lower than those with other types of mental health disorders.3 This is attributed to several treatment barriers people living with eating disorders face when they need help.
There are so many systemic barriers to eating disorder treatment, including, but not limited to:1,2
There is no denying that there is health inequity in the United States, with the main drivers of health inequities including income and wealth, employment, education, and social environment, amongst others.4 Health inequity can lead to a myriad of barriers to accessing eating disorder treatment, including, but not limited to:
The lack of culturally competent treatment providers can lead to a host of treatment barriers, which include:
If you’re of a low income, the financial barriers to treatment can seem impossible. They include:
One of the major logistical barriers to treatment is geography. Many people seeking eating disorder treatment live in rural areas and locations far from suitable treatment centers. Other logistical barriers include:
In reality, this is probably not an exhaustive list of the barriers to treatment disproportionately experienced by marginalized and minority groups. There are many other barriers surrounding biased diagnoses, lack of understanding of treatment providers working with pregnant, male, athlete, LGBTQ+, etc., clients, lack of treatment of co-occurring disorders, long waitlists for care, no consideration for religious dietary needs, and so much more.
These varied barriers to treatment clearly show a clear need for more equitable and accessible eating disorder treatment. These barriers have severe consequences, as eating disorders are the second most fatal mental illness, with one person dying directly from an eating disorder every 52 minutes.5
Project Heal was founded in 2008 to help people access treatment by breaking down systemic, healthcare, and financial barriers to healing eating disorders. Through their work, Project Heal hopes to change the system and, in the meantime, provide life-saving support to people with eating disorders that the system neglects.
Equity is important to everyone at Project Heal. Therefore, they intentionally prioritize those who have been harmed by or excluded from the eating disorder field due to biases such as weight discrimination, racism, transphobia, ableism, classism, and homophobia.
Recognizing that traditional eating disorder treatment is not suitable for everyone, Project Heal connects beneficiaries to care that will most likely empower their progress toward their desired outcomes.
Contrary to common misconceptions, eating disorders don’t discriminate. They affect people of all ages, gender identities, sexual orientations, races, ethnicities, body shapes, and socioeconomic statuses.
To paraphrase, Rebecca Eyre, the CEO of Project Heal, makes it clear to marginalized groups that treatment centers are a safe place for everyone. One way to do that is to show representation in websites and marketing materials.
While organizations like Project Heal help to reach and treat “exiles” of the eating disorder community, it’s clear that more needs to be done.