I’ve lost count of the number of therapists I’ve consulted with over the years. Why? Because I cycled through so many in my search for one (just one!) who understands the complexities of eating disorders.

Multiple times, I’ve had to leave the affordability of my insurance network and instead pay out of pocket for providers that wouldn’t be covered. But this expense was not sustainable.

Very little has changed or improved when it comes to finding eating disorder treatment. It’s no wonder so many eating disorders go undetected and, therefore, untreated.

But a proper diagnosis and insurance gaps aren’t the only barriers to getting effective care for disordered eating. In this post, I’ll explore a few other reasons why people may be reluctant and/or unable to get the treatment they need for a disorder that affects more than 30 million people.

Barriers to eating disorder treatment

Unawareness of a problem

Before seeking help, there needs to be the recognition of a problem. In today’s pervasive diet culture, such problems can be hard to detect.

But the truth is that a lot of common dieting behaviors are dangerous and can serve as a gateway to disordered behaviors. These normalized meal and exercise regimens that are part of widely accepted diets mean dieters might not realize what they’re doing is problematic until it’s too late.

Uninformed medical providers

Once someone feels like their behaviors might be an issue, the next step is usually to consult a healthcare provider. However, your primary care physician might not be equipped to answer your questions about disordered eating. Worse, they may even encourage your behaviors or praise you if you’re in a smaller body, as some still consider weight and BMI to be indicators of health.

Racial and gender disparities

The media (typically) show us that eating disorders are white, affluent, female diseases, but this is far from an accurate picture. Because of this inherent bias, people from communities other than those portrayed through media and textbooks might be reluctant to seek care.

“When compared with national prevalence rates of eating disorders, health care professionals missed around 50 percent of diagnoses in Black youth in the U.S. Diagnostic bias likely underpins this underdiagnosis: presented with identical eating disorder symptoms, clinicians are more likely to diagnose a white patient than a Black patient. —Source: Scientific American

Because of these disparities in diagnosis and treatment, researchers struggle to recruit members of underrepresented communities for eating disorders research, thus precipitating the problem even further.

Limited access to care

If you set out with the task of finding an eating disorder specialist in your area, you’ll quickly notice that they are few and far between. Qualified, informed, and insurance-accepting eating disorder therapists just aren’t as common as they should be.

Even web-based therapy platforms like BetterHelp allow prospective patients to search for therapists based on their area of expertise. Unfortunately, eating disorders are not listed among the available treatment focuses, despite the fact that the site has an entire section of blog posts dedicated to the topic.

This digital and diagnostic desert can be discouraging and can make people give up their search altogether.

Financial barriers

With very few providers out there, most of whom do not work with insurance companies to bring down rates, the likelihood that patients will need to pay out of pocket is extremely high. And fees aren’t cheap.

It’s been reported that the average annual cost of eating disorder treatment is about $11,800 per person, a figure most people simply cannot afford. These financial obstacles can make treatment seem like a far-off dream.

Those who can afford a fraction of this cost will only receive a fraction of the care they need to get better.

The post-treatment predicament

Even people who have the means to pay for inpatient treatment may find that this method is not always an end-all solution.

The gap between treatment and real life may seem small, but to someone in eating disorder recovery, it’s a valley that seems to stretch for miles.

What can be done?

In the face of all these barriers, what can people who want help for their eating behaviors do?

Explore all treatment options

Very few people can afford or have the flexibility to participate in inpatient treatment, which means searching for alternative treatment options. And while accessibility and available, informed providers are still hard to find, the landscape has gone from impossible to slightly possible.

A quick Google search might reveal a free support group in your area or virtually. Check out ProjectHEAL’s list of eating disorder support groups for different communities.

Be realistic about relapses

In the world of eating disorders, relapses happen; in fact, they are very common.

To lessen the brunt of imbalance and turn a “relapse” into a “lapse,” make a list of trustworthy people you can reach out to to help you through it. Or keep a notebook handy so you can journal about any intrusive thoughts.

Encourage your local officials to fund research

To understand more about eating disorders and all their presentations, we need more research. Currently, there are substantial gaps in treatment modalities for marginalized groups, older adults, and men. The more research we have, the better we’re able to treat the growing number of eating disorders and all their manifestations.

To learn how to get involved and contact your local officials (in the U.S.), visit the Eating Disorders Coalition (EDC) website.

The above is hardly an exhaustive list of how to solve the greater treatment access issue. The path toward affordable and prevalent care is long and arduous. But this issue is not an invisible one, which is why there are resources like free support groups and organizations like the EDC, working to make care more available.

In the meantime, check in with yourself, often and thoroughly. Take some deep breaths. Recognize the present moment. And above all, take care of yourself. You’ll want to be here when we finally have eating disorder care for all.

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