We’ve all experienced that one family member or friend who we clash with politically, socially or otherwise at holiday dinners. The upside, though, is that most times, we can leave both the table and the conflictful conversation.
Loved ones with disordered eating habits or who have a history of an eating disorder don’t always get that luxury. Many times they bring an uninvited guest to the table, which many survivors nickname “ED,” or another name to identify their condition and the intense internal dialogue that can accompany the diagnosis.
So, while many celebrations from different global traditions center around food, dinner table topics, such as extra calories, exercise routines, and negative body image, can be triggering for people with eating disorders — let alone, the plate in front of them.
And if you don’t think ED will be at your dinner table, think again: Roughly 30 million Americans struggle with an eating disorder at some point in their lives.
Eating disorders can affect anyone
The common myth is that eating disorders aren’t serious, when in fact, eating disorders are among the deadliest mental health conditions, claiming 10,200 lives each year, which is one death every 52 minutes.
And eating disorders do not discriminate; they affect people of every age, race, size, gender identity, sexual orientation and background. However, there are particularly significant racial disparities in terms of diagnosis and treatment of eating disorders.
For example, one study reported that Black teenagers are 50% more likely than white teenagers to display bulimic behavior, such as binging and purging, but another study suggests that bulimia nervosa is underdiagnosed in Black and low-income girls.
Additionally, research shows people of color are significantly less likely to receive help for their eating issues, and that doctors are less likely to ask BIPOC patients than white patients about eating disorder symptoms.
Treatment for eating disorders
Eating disorders are complex illnesses that oftentimes require coordinated care from various areas, such as psychological, medical and nutritional. And for those who do receive treatment, 60% of individuals with eating disorders make a full recovery.
However, support options for people with eating disorders are often inaccessible, even as global eating disorder prevalence has nearly doubled from 3.4% to 7.8% since 2000.
While the level of treatment — such as outpatient, intensive outpatient, partial hospitalization programs or residential care — depends on the individual, unfortunately, most people with eating disorders in the United States do not receive any form of treatment, oftentimes because of the potential costs, making it most inaccessible to vulnerable populations.
One 2020 report found that the average cost for intensive treatment in a residential facility specifically for eating disorders was more than $1,200 per day, with an average treatment duration of one month. And this doesn’t account for any outpatient mental health or medical care following discharge.
And although some insurance companies will cover the costs, and oftentimes healthcare facilities will offer grants or scholarships, still only 1 in 10 people with an eating disorder will seek and receive treatment.
It’s clear that there’s a lot of work to be done politically and socially to bring more resources to eating disorders and treatment. So, what can we do to help?
‘It starts at the dinner table’
As family members, friends, community members and contributors to society, we all have a role in bringing awareness to eating disorders and the various disparities — and it truly starts at the dinner table, and every table.
Try to take a step a back and pause before nudging about food to loved ones.
Other helpful tips for making your guests (and their “uninvited” plus-one, ED) more comfortable at your table include:
Educate yourself about different eating disorders and their symptoms
Avoid commenting on physical appearance
Check in with your loved ones and support them in their journey as they wish to be supported (if they feel comfortable sharing)
Respect your loved one’s boundaries
Remember that ED can be silent to some but loud to others