Black Women Are Failed When It Comes To Eating Disorders

Jasmine Leyva was unaware she had an eating disorder. "I only saw eating disorders associated with women who threw up their food or starved themselves and I didn’t fit those paradigms. I was not able to label my problem," she says.

When Jasmine, 35, was in college, she found herself in an abusive relationship. Food became her distraction and eating was a desperate act to ease the pain she was feeling. "When I would binge eat, I would think about nothing but the food, the drive to multiple places to get the food, the taste of the food, the guilt I would feel about eating the food, and all of these thoughts would distract me from the fact that a man was verbally and physically abusing me."

"I never learned about eating disorders in the context of Black women," Jasmine notes. "I also thought, ignorantly, that eating disorders were acts of vanity performed by privileged girls who wanted to fit in with their cheerleading squads, which was very different from my narrative. Binge eating was my survival mechanism, a comforting way for me to cope with abuse, loneliness and stress, and still be strong. Because narratives like mine were overlooked, I didn't register my behaviour as a clinical eating problem."

Jasmine's binge eating became so bad at one point that she overdosed on laxatives to alleviate the discomfort, which caused rectal bleeding. Her then boyfriend drove her to the hospital and left her there – despite Jasmine wanting him to stay – because "he didn’t feel like it".

Jasmine was largely able to fly under the radar due to her body conforming to the stereotypical image of a Black woman’s shape. "I was naturally born with that build, which is why nobody knew I needed help," she says. "Binge eating is a very nuanced problem because it involves overeating and it is common in the Black community, for women especially, to be celebrated for overeating. It's almost like a badge of honour when people say, 'That girl show can eat.'" 

The NHS reported that between 2017 and 2020, there was a 216% rise in the number of Black people being admitted to hospital due to eating disorders. Admissions leaped from 69 in 2017-2018 to 218 in 2019-2020. Yet there is a lack of research on Black women and binge eating.

Jasmine never received treatment for her eating disorder, which is not uncommon. Black women are statistically less likely to receive treatment for an eating disorder than their white counterparts.

London-based sustainable fashion journalist Armelle Ferguson, 28, says her eating disorder started when she was 16. Growing up in Guadeloupe, conversations about eating disorders were rare. "I was never diagnosed. I was not eating, exercising way too much, counting my calories, lying about if I had already eaten, and making one pack of biscuits last for a day or two."

Her mother grew concerned and forced her to see a therapist and a nutritionist. "I was in complete denial and didn’t think anything was wrong, even though I was melting in front of her eyes," Armelle says. "She was scared."

The nutritionist recommended a healthy diet for Armelle and assured her that she would not gain any 'unnecessary' weight. Armelle, used to the restrictive diet linked to her undiagnosed eating disorder, gained 14kg within a year and felt betrayed. When she moved to France alone during her 20s, her eating disorder worsened. Her diet largely consisted of Diet Coke, cigarettes and coffee. "I even started smoking because it was an appetite suppressant. That was my diet."

Now, Armelle has quit smoking, has a strong support system and feels more in control, adding that she's "in a better place" in her life. Jasmine is currently working on a new documentary called The Invisible Shame to give women like her a platform to speak about eating disorders. During her struggle with binge eating, she refused to seek help and tried to fit into the 'strong Black woman' trope. She’s past that now. "Luckily, I'm finally at a place of true strength where I can ask for a life raft if I feel myself drowning."

The media portray white, skinny, affluent girls as the only victims of eating disorders but this is a dangerous stereotype which ignores anyone who is 'other' and places them in a precarious position. "Research around eating disorders is limited, and even more so around eating disorders among Black women," says Tom Quinn, director of external affairs at Beat. "There is certainly a need for more resources that cater to the needs of Black women with eating disorders, and more work needs doing in this area, including by Beat."

Black women are rendered invisible when it comes to the issue of eating disorders. "I think with many things in society today," says therapist Myeisha Brooks, "the invisibility comes from a space of not acknowledging how systemic racism, overt/covert racism and all the forms of racism consistently do not allow for things like this to be seen." Black women become the forgotten victims of eating disorders, she adds.

When the media, scientific studies and academic papers have so little information concerning Black women and eating disorders, the problem becomes an invisible threat. There is a palpable lack of care when it comes to addressing eating disorders within the Black community, as well as addressing access to treatment. A 2016 study on access to mental health services among Black communities in southeast England noted: "Little research has been conducted to understand the barriers faced by BME communities to access the appropriate service."

Clinical psychologist and expert on eating disorders Kelli Rugless says that now is the perfect time to dispel myths about eating disorders. "Eating disorders are a social justice issue," she says. "They are at the intersection of racism, patriarchy and diet culture. I believe that if we can start to discuss the context in which eating disorders develop, food deserts, food swamps, blind spots in healthcare, lack of access to private treatment facilities and exposure to trauma, we can remove the stigma, which [will invite] more open discussion and hopefully an increased willingness to seek treatment."

The relationship between the Black community and medical institutions has always been contentious. This is evident in a recent report published by the House of Lords and House of Commons Joint Committee on Human Rights, titled "Black People, Racism and Human Rights". The report provided evidence that Black women are five times more likely than white women to die during pregnancy. The discrimination does not end there. The same report found that four in five Black women do not believe that their health is equally protected by the NHS compared to the health of their white counterparts.

A 2006 study revealed that clinicians were unable to spot the symptoms of an eating disorder in a Black patient where they had been able to spot them in a white patient. Ninety-three percent of participants were able to recognise an eating disorder in white patients but only 79% were able to correctly diagnose an eating disorder in Black patients.

Commenting on the invisibility of Black women in healthcare, Kelli says: "Racial bias, as well as an overall lack of training in how to assess and treat eating disorders, results in Black people being misdiagnosed with obvious symptoms of an eating disorder."

Combating the issue of eating disorders within the Black community is a battle on two fronts. Firstly, we must reckon with the fact that media-driven stereotypes of eating disorder sufferers do not cover the breadth of people who are affected. Secondly, we must begin to tackle the mental health stigma within Black communities.

Myeisha highlights the importance of the Black community acknowledging mental illness, adding that it can have a drastic positive impact. "There is this notion in the Black community that speaking about or sharing an experience related to mental health is a sign of weakness," she says. "I think it is time that we start to look at that as a strength. It takes a lot of courage and humility to acknowledge that you need help and may not have all the answers. The important thing to remember is that we have many supports available for those in need."

If you are struggling with an eating disorder, please call Beat on 0808 801 0677. If you are struggling with your mental health, contact Mind on 0300 123 3393 or text 86463. If you need urgent help, please call Samaritans on 116 123.