Since the Black Lives Matter protests crescendoed during the late spring and summer of 2020, more and more clinicians have been grappling with how to change their practice standards to provide equitable, anti-racist care. The shift toward inclusive care for historically marginalized groups, specifically Black communities, is imperative for improving healthcare outcomes in the field of eating disorders and beyond. Specifically, clinicians must acknowledge how privilege impacts access to care, recognize how whiteness can unveil itself in the frameworks we commonly utilize, and explore how both of these hinder anti-racist initiatives.
Although Intuitive Eating and Health at Every Size help to challenge and transform harmful weight-centric paradigms, they should not serve as the end-all-be-all of inclusivity. As Jessica Wilson and Whitney Trotter reminded us in How Whiteness Shows Up in Your Work and What to Do About It, white professionals created these frameworks, and most of the research that supports them involves white participants. Since they remain widely unstudied among Black participants, we cannot yet call them evidence-based for these communities. Further, the majority of recognized leaders and experts in the field remain white women. Solely relying on these frameworks, then, ignores the lived experiences, needs, ancestral knowledge, and trauma within Black communities.
How might these oversights show up when working with clients? The following assumptions name just a few:
- Access to food
- Access to continuous healthcare
- Being able-bodied
- The ability to trust one’s body
Further, these frameworks can harmfully imply that any person can achieve “health” by trusting their body’s cues. This neglects the realities that “health” is not one-size-fits-all and that not everyone can embody how our culture has narrowly defined it – specifically given that Black individuals face the additional hurdles of systems of oppression daily. Environmental contexts that disproportionately impact Black communities, for instance, include limited food access, lack of equitable healthcare, and lower levels of wealth. Intuitive Eating and Health at Every Size, while perhaps gesturing to such inequalities, predominantly focus on the individual. In the face of such insidious systemic barriers, this is not enough.
We cannot ignore the racial trauma that Black communities endure. We cannot neglect the reality that this can disconnect Black folks from their body’s wisdom, signals, and cues. Critiquing these frameworks does not mean that they are unsuccessful or unnecessary. Rather, it creates space to improve our care for marginalized communities. Becoming a better clinician for Black folks begins with addressing how whiteness shows up in our practice, being willing to face both creativity and discomfort.
What might an anti-racist eating disorder field look like? When providing care for Black clients with eating disorders, we need to get to the root cause. We can start by advocating for systemic change, such as working toward food access for all. We need to remember that rates of trauma are higher within the Black community, and we need to address that in our care. Most importantly, we need to recognize the eating disorder field is an exclusive one. We need to prioritize Black-identifying providers in this space so that Black clients can truly be represented, seen, and heard.
Jessica Wilson and Whitney Trotter’s webinar, How Whiteness Shows Up in Your Work and What to Do About it, explores the role whiteness plays as a barrier to inclusive and anti-racist care. They examine the frameworks commonly used in the non-weight-centric dietetic space and ways we can get involved. Find Jessica and Whitney’s webinar in our members-only library.