Beauty in Every Shade: A Look at Racial and Ethnic Diversity in Eating Disorder Treatment

By: Joy Ssebikindu, LPC

A visibly anxious young girl walks into your office with her parents for an assessment; however, these symptoms are far beyond any illness that her parents have ever seen or heard of – markedly an Eating Disorder. Your new client shyly answers your questions, somewhat honest regarding her eating disorder behaviors and reluctant to say that she is ready for something different as she is not sure that she is. Her ideal: what she sees marketed as beautiful – skinny, young, and skin resembling the “nude” of the Crayola crayon. How do you tell your young client that her ideal is not attainable? How do you compassionately convey to your client, of minority descent, that they will never be a White girl, with natural blonde hair and blue eyes – that their eating disorder will never fulfill that desire?

Although it is highly recognized that Eating Disorders touches all genders, races, socio-economic status, the field is at the brink of tackling best practices in treating such disorders with consideration for the intersectional markers. Truth be told, as an African American female therapist, I have struggled through conversations with Black girls and women who simply wish to be someone else. In being someone else, they truly believe that their world would be different and they will be embraced wholeheartedly by the others. And as one of the few African American females in this community, I often wonder how my White colleagues would handle such a conversation with a client who does “look” like them. Better yet, I wonder if such a conversation would take place.

As the face of Eating Disorders evolves, here are a few things to consider:

1.     Check your biases at the door: Begin each new relationship afresh, open to their interpretation of their experiences.

2.     Open the conversation: Diversity and the –isms associated can be difficult and daunting to discuss for some. Ground yourself and display a willingness to listen. Globally, this is the beginning of great therapeutic work.

3.     Be curious about how your client makes meaning of their race, age, creed, etc.: Know that though they be familiar, every experience is unique to the individual; therefore, seek to understand how they have made meaning of their differences.  

4.     Be sensitive to the family and community supports that your client may have or not: Recognize that mental health, eating disorders, and the idea of treatment may be a novel idea for the family and communities from which they come from.

5.     A note to treatment centers: Be aware that representation matters so seek to diversify your staff. I did not fully understand the value that I had in this community until recently – value that has been found in every ‘thank you’ that I have received from people of color for being willing to engage in a profession/specialty not yet truly embraced by all. 

I am curious how you “treat” the unfamiliar? I want to hear how you as a clinician bring awareness to your client’s differences without shaming them for their uniqueness. Email me at Consider the conversation open…

Joy Ssebikindu, LPC, NCC is a “Double ‘Dore” having graduated from Vanderbilt University with her BA in Sociology and Child Development, and her M.Ed in Clinical Mental Health Counseling. Shortly after finishing graduate school, Joy moved to Atlanta in pursuit of a career as a mental health therapist, where she continues to provide therapeutic services today in her private practice and as the Primary Therapist at Center for Discovery.