My first introduction to eating disorders as a diagnosis were Lifetime movies showcasing thin white teenage girls. The parts that I could relate to were the unbearable fear of being fat and unbridled disgust at every mirror I encountered. In middle school, an old childhood friend and I connected on our mutual obsession with our bodies—sharing weight loss tips that reinforced one another’s disordered eating—congratulating each other when we managed to lose a few pounds.

But that wasn’t considered a real eating disorder. We were not so thin you could see our ribs like in the movies, but we looked in the mirror and wished we could. We were just two Black girls trying to appease a culture that had convinced us we didn’t deserve to feel safe in our bodies.

In later years, my friend got closer to resembling the white girls in lifetime movies before getting treatment. I, on the other hand, maintained my unhealthy relationship to food in plain sight, still occupying a body that was constantly being policed, especially by family. Ironically, when I look back on old photos of myself I was just barely chubby. But I remember vividly looking in the mirror and seeing a version of my body that didn’t exist.

In the 2000s and earlier, the body standard skewed towards very thin. In fact, the bar for being fat and “undesirable” was extremely low. I observed this in many of the tv shows I watched as a teenager. All the characters with any sort of curves became the fat friend. It was especially prevalent with Black women and girls.

Despite the ways Black folks in general were being force-fed media depictions that scrutinized our bodies, somehow we get left behind in conversations about eating disorders.

Thankfully, the tide is slowly, but surely changing. Today there are Black therapists and activists shedding light on the unique issues that Black and Indigenous People of Color face when navigating disordered eating by pushing for more inclusive advocacy and treatment as well as providing safe spaces for folks in larger bodies.

One of the first people whose work really supported my journey towards improving my relationship to both my body and food is Alishia McCullough, a mental health therapist and the owner of Black and Embodied. She was drawn to specializing in eating disorders among BIPOC individuals when observing not only how white the eating disorder field is, but also the lack of Black patients receiving adequate support. According to McCullough, this discrepancy has created a much larger problem in the field:

“All of the diagnostic criteria that we use has been normed and standardized on white bodies…there’s no way a field that has primarily [diagnosed] mental health conditions that have been normed and standardized on white bodies can relate or translate to the experiences of black people. And so that’s when I started my own work of: well, what are the roots? What are the threads that have contributed to the eating disorders in our communities? How is that different for us? What is the language that we’re using?”

In addition to not having culturally competent diagnostic criteria, which oftentimes leads to Black folks being underdiagnosed, McCullough emphasizes the ways capitalism, colonialism and white supremacy influences how we relate to and exist in our bodies.

Safiya McHale, a therapist and writer, observed the same issues when encountering clients. Their work seeks to dismantle ideas that are reinforced in treatment settings and in the media of eating disorders only occurring among certain populations. They are also a proponent for educational content and safe spaces being readily available for folks with multiple marginalized identities. As McCullough touched on earlier, a lot of the biases in eating disorder treatment are the differences in which Black folks talk about their relationship to food. McHale stresses the importance of an intersectional approach to supporting folks with eating disorders:

“What I’ve seen happen over and over is treatment or healing is [being] centered around looking at food and eating through this academic thin, white lens…it’s like the eating disorder is the priority. We’re putting everything else aside…there’s this prioritization of the false idea that eating and the relationship to food is the only piece of it, or the strongest or biggest piece of it. But when people approach it that way, they’re missing the whole person. And you should be helping a whole person heal, treating a whole person, helping a whole person discover their lives.”

The work of advocating for an intersectional understanding of eating disorders is happening among several of McCullough and McHale’s peers. One of the ways this is happening is through the BIPOC Eating Disorders Conference which takes place next week. Led by dieticians Whitney Trotter and Angela Goens, the conference is centered around addressing several issues including academic gatekeeping and the lack of BIPOC representation in treatment settings and eating disorder research. McCullough believes this conference is important in really moving the field in a more inclusive direction:

“What I really hope with this conference is that it elevates the voices of all the BIPOC folks that I know are part of it. But then outside of elevating their voices and their words, it also really gives a myriad of experiences to what we deal with as BIPOC folks…[the speakers] at the conference are saying, here are the clients I’m working with, here’s what I’m seeing or here’s my lived experience….we definitely have come a ways, but we have a long way to go in this field and the way that we talk about eating disorders in Black communities.”

As with other health concerns, systemic racism is often one of the primary barriers to Black folks getting the care they deserve and need. It is why so many of us have anecdotal stories of our personal experience with disordered eating and even watching people we love struggle with it. When you have therapists and doctors with a limited view on how eating disorders manifest in individuals based on their race, gender and other identities, it reinforces the narrative that it doesn’t exist in our communities.

This is why this work is so important. It is not just about eating. It is about how we relate to our bodies, what is impacting that relationship and then figuring the healing modalities that are most aligned with our needs.

If you want to learn more about eating disorders through a holistic lens, check out McCullough’s course “Reimagining Eating Disorders 101.” You can also follow McHale on Instagram: @intersectionalrecovery to find more about her work and find additional learning resources.