People of color with eating disorders face cultural, medical stigmas

Almost 30 million Americans will have an eating disorder in their lifetime. During the pandemic, the number of people seeking treatment has jumped. But as Amna Nawaz reports, eating disorders are often overlooked in people of color.

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  • Judy Woodruff:

    Almost 30 million Americans will have an eating disorder in their lifetime. During the pandemic, the number of people seeking treatment has jumped.

    But, as Amna Nawaz reports, eating disorders are often overlooked in people of color.

  • A warning:

    This story discusses the behaviors associated with these conditions.

  • Amna Nawaz:

    For years, Tre Brown hid her disordered eating from her family.

  • Tre Brown, Suffers From Eating Disorder:

    It's a stigma to have an eating disorder in my community. One of my cousins made the statement: "Black people don't have eating disorders. That's a white person disease. We know how to eat."

  • Amna Nawaz:

    When most people hear the phrase eating disorder, what do you think they picture? Who do they think of?

  • Tre Brown:

    I think they picture a Caucasian female.

  • Amna Nawaz:

    It's a widespread stereotype.

  • Sara Molina, Suffers From Eating Disorder:

    In my head, it's always like a like a white girl, like a young white girl.

  • Gloria Lucas, Nalgona Positivity Pride:

    In the media, it's always a thin white, middle-class, upper-class woman.

  • Amna Nawaz:

    But that's not the full picture, says researcher Karen Jennings Mathis.

    Karen Jennings Mathis, University of Rhode Island College of Nursing: The lifetime prevalence of any eating disorder among women of color is about the same or greater compared to white women.

  • Amna Nawaz:

    And that could be an underestimate, since people of color are less likely than white people to have been asked by a doctor about eating disorder symptoms, says psychiatrist Erikka Dzirasa.

  • Dr. Erikka Dzirasa, Psychiatrist:

    Black women, for instance, are 25 to 40 percent less likely to be diagnosed with an eating disorder than white women. You may not necessarily even be screened for an eating disorder if you are a person of color.

  • Amna Nawaz:

    Brown, now 36, has struggled with anorexia and bulimia since she was a teenager. But she's never gotten treatment.

  • Tre Brown:

    You have insurance companies fighting you, saying, oh, just eat. You have the doctors fighting you, telling you, just eat. So it's really hard. It's extremely hard.

  • Amna Nawaz:

    Do you think it was even harder for you because you're a Black woman?

  • Tre Brown:

    Oh, of course. Matter of fact, I went to a doctor's appointment back in October. The doctor told me: "Your eating disorder is not serious enough."

    And I said: "So, if I die, will it then be serious enough?"

    They don't take African Americans serious.

  • Amna Nawaz:

    Eating disorders are among the deadliest mental illnesses, causing over 10,000 deaths a year. Brown's eating disorder has taken an enormous toll on both her and her girlfriend, who did not want to be identified.

  • Tre Brown:

    She goes to support groups because of me. And we have had very difficult conversations. She's like: "I'm afraid I'm going to wake up and you're going to be dead. And I can't carry that on me. So I'm putting up my boundaries. My mental health has been affected because of your eating disorder."

  • Amna Nawaz:

    Brown moved out of the apartment they shared. She dropped out of her Ph.D. program. She stopped calling her 88-year-old grandmother, whom she used to talk to multiple times a day.

  • Tre Brown:

    To me, eating disorder's like a whole 'nother person, and that person takes control over you. So that person will lie, manipulate, do whatever it is that it can do to keep that relationship and that bond with you.

    And that — if that means tearing down relationships and dynamics between your family, your friends, your mate, your job, your school, it's going to do it.

  • Amna Nawaz:

    For many, the isolation and uncertainty of the pandemic worsened or even triggered their eating disorder.

    Sara Molina was a thriving high school senior when COVID hit.

  • Sara Molina:

    And then everything shut down.

    And it kind of felt like very, like, out of control. And then things just kept getting closed for longer and longer and longer. And it was like, oh, maybe we will graduate? Oh, no, we're not graduating. Then it was like, oh, like, our graduation might be, like, socially distanced. Then, no, it was like a PowerPoint video.

  • Amna Nawaz:

    Sports were also canceled.

  • Sara Molina:

    I played softball since I was like 3 or 4, and it was my senior season. And it was just starting. And then I never got to have it. And then also not being able to exercise or go out, when that's like what I wanted to do.

  • Amna Nawaz:

    So, Molina controlled what she could, her eating. When she got to college, her anorexia became more serious.

  • Sara Molina:

    I spent my 19th birthday starving myself.

  • Amna Nawaz:

    She described how it ruined her birthday in a column she wrote for the Indiana Daily Student.

  • Sara Molina:

    "When we cut the cake, I had a piece. After all, it was my cake and my whole family was watching me. I took a bite and almost began to cry. It was a banana cake with white whipped cream frosting. It was one square piece of cake. Why was it so hard for me?"

  • Amna Nawaz:

    Molina knew she needed help.

  • Sara Molina:

    I used to go on bike rides a lot or runs or walks, and I couldn't do any of that stuff just because my legs were so weak. And I would notice, when I was driving, I would have to take breaks to pull over because my hands and my legs were shaking so much.

    And, like, I couldn't find the strength to push down the pedal and stuff that.

  • Amna Nawaz:

    Her doctors recommended inpatient treatment. But most centers were full.

  • Sara Molina:

    There were no spots open. And all the places we called, like, they would just be like, sorry, no, you can't come to this one.

  • Amna Nawaz:

    Molina ultimately got treatment last summer. But, as eating disorders spiked and medical admissions more than doubled in the pandemic, Dr. Dzirasa says the demand for help has far outstripped supply.

  • Dr. Erikka Dzirasa:

    I don't know that we have enough resources or providers to actually meet the need, especially when we think about individuals experiencing eating disorders that are coming from different ethnic backgrounds, because we have to make sure that they are receiving appropriate and culturally appropriate care. And that's really, really hard to find.

  • Amna Nawaz:

    Gloria Lucas runs a support group for those with eating disorders in communities of color, Nalgona Positivity Pride.

  • Gloria Lucas:

    So, what it means is that you're big booty positive.

    (LAUGHTER)

  • Amna Nawaz:

    Lucas sells merchandise on Etsy to raise awareness of people of color with eating disorders. Growing up the daughter of Mexican immigrants, she felt alone in her experience with binge eating and bulimia.

  • Gloria Lucas:

    Throughout those years, there was no awareness of it, no doctor, my parents. It's challenging to hold those conversations and especially when there's so much stigma on mental health. And then there's so much hatred towards fatness. And so it just makes that conversation — like, it's hard.

  • Amna Nawaz:

    So, Lucas started her own conversations. She posts regularly about positive body image and eating disorders to her 144,000 Instagram followers. But even with the support of her online community, the pandemic proved difficult.

  • Gloria Lucas:

    The eating disorder got worse. I mean, I feel — I always say that eating disorders thrive in isolation, and the whole pandemic was people being isolated.

  • Amna Nawaz:

    Lucas went to an outpatient program, which she says is a luxury.

  • Gloria Lucas:

    I was only able to go to treatment because I was offered a scholarship. A lot of folks don't recognize that financial hardship that Black, indigenous, people of color experience or low-income folks in general. And treatment is very expensive.

  • Amna Nawaz:

    Lucas faced other barriers to treatment as well.

  • Gloria Lucas:

    Sometimes, you have to explain yourself more than one way. A lot of these treatment centers are not created with people myself in mind. And what I mean by that is culturally affirming spaces, rather than inclusive, right, because the whole idea of inclusive is that there's already a standard.

  • Amna Nawaz:

    Jennings Mathis has studied diversity in the eating disorder field.

  • Karen Jennings Mathis:

    The majority of individuals who are in this field do identify as white, and the majority are female. And so that may mean that individuals who have an eating disorder and who identify as a person of color may not feel they fit within that community.

  • Amna Nawaz:

    Tre Brown is trying to get her life back together.

  • Woman:

    Hello?

  • Tre Brown:

    Hi, grandma.

  • Amna Nawaz:

    She recently called her grandmother for the first time in two months.

  • Woman:

    It's been so long. Hallelujah, Jesus. Thank God.

  • Amna Nawaz:

    Brown hopes to access treatment soon with the help of a nonprofit.

  • Tre Brown:

    I want to be able to sit down with my family and enjoy a meal. Do you know the last time I sat down with my family and ate a meal? 2009. I want to be able to do those things. And with this eating disorder, it is not possible, unless I get help.

  • Amna Nawaz:

    Brown and so many we spoke to for this story have a message for people of color out there who may be struggling: You're not alone.

    For the "PBS NewsHour," I'm Amna Nawaz.

  • Judy Woodruff:

    And if you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Helpline or get 24/7 crisis support by texting NEDA to 741-741.

  • Editor’s Note:

    You can also contact the following organizations to find additional help for eating disorders:

    Nalgona Positivity Pride is an in-community eating disorders and body-positive organization dedicated in creating visibility and resources for Black, Indigenous, communities of color.https://www.nalgonapositivitypride.com/

    Project HEAL offers help with clinical assessments, treatment placement, navigating insurance, and cash assistance.https://www.theprojectheal.org/

    WithAll issues grants to cover expenses to assist with eating disorder treatment.https://withall.org/

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