LGBT & Food: The Uneasy Relationship

by Joan Allison & Danielle McBride | photos courtesy of Fairhaven Treatment Center

Similar to any mental health illness, eating disorders and negative body image do not discriminate- and can affect anyone from any cultural, racial, sexual, or socioeconomic background. However, these are especially prevalent among members of the LGBTQ+ community. The factors that lead to eating disorder for the general population are similarly linked to those that affect the LGBTQ community, from fear of rejection to PTSD to an inability to meet body image ideals. However, the additional stressors have left this population particularly vulnerable, such as fear of coming out, harassment in schools/the workplace, and an either genuine or “felt-sense” of disapproval/lack of support from one’s family and/or community.

According to 2018 research performed by The Trevor Project and NEDA (National Eating Disorders Association), the percent of LGBTQ youth affected by this illness is further critical to emphasize and spread awareness surrounding. In this study, a sample of 1,305 LGBTQ- identified youth from the ages of 13-24 in the U.S. was used. Of these, 54% had already been diagnosed with an eating disorder. These percentages are laid in comparison to 5% of their heterosexual peers, providing a stark contrast. Transgender youth who identify as straight were found to be most at risk. of this population , 71% had been diagnosed with an eating disorder — and most commonly, Anorexia Nervosa. Furthermore, 50% of the surveyed youth had not yet been diagnosed, though they suspected that they had an eating disorder citing their disordered eating patterns, thoughts, and behaviors. The data also show a dangerous intersection between eating disorders and suicidal ideation in this population; 58% of those surveyed said that they have considered self-injurious-and even deadly behaviors as a means of grappling with their illnesses.

Donya Ahmadian is the LGBTQ advocate at Memphis- area Fairhaven Treatment Center for eating disorders and trauma. She oversees the center’s diversity and inclusion outreach and has assumed various roles in the Center. She is also a Level-1 Internal Family Systems (IFS) practitioner and works closely with clients to help them learn the tools to address their emotional traumas and unearth the coping mechanisms needed to overcome their various stressors such as anger or shame. Clients learn to better understand the true purpose and protective intent under which their eating disorder formed, the various emotional reactions and coping mechanisms they’ve used to protect themselves from underlying hardship and trauma. Understanding and coping with these emotional reactions can be key factors towards healing.

“What makes food and eating such a weapon for cross mental illness is that it’s so directly linked to our perception of our self-esteem, self-image, and also, overall, our felt- sense of control in our lives ,” Ahmadian said. “Oftentimes, you might see various extreme eating patterns, such as severe restriction paired with increasing substance/ laxative/diet pill use, coupled with extreme exercising to fit this perceived sense of an idealized body. This is visible amongst cis-normative standards, but these vulnerable populations feel not only equal, but even greater stressors alongside this image. It is nothing short of heartbreaking. At baseline (take our transgender adults and youth, for example), these patients are already contending against such misalignment between their physical gender identifies and their felt-sense of Self. This profoundly rooted sense of dysmorphia can acutely aggravate an already negative cognition towards body-image and eating behaviors.”

Chefs are on staff at Fairhaven and prepare delicious, balanced meals for patients including red beans and rice, chef salads, soup and cheese toast, and salmon an asparagus.

Every eating disorder can affect everyone differently. Anorexia nervosa, bulimia nervosa and binge eating disorder are the most commonly identified eating disorders. But even disorders like body dysmorphia, Avoidant Restrictive Food Intake Disorder (ARFID) and Other Specified Feeding or Eating Disorders (OSFED) can occur. One’s accessibility to food, especially among youth, can play a part in the development and mode of onset that the eating disorder is born out of.

In her direct experience, Ahmadian sees that the lack of social support (familial/ community), or lack of a felt- sense of this support, plays a pivotal part in seeking treatment and recovery. This lack of support is something that many LGBTQ people feel, especially youth. “Oftentimes we can feel like everything in our lives is out of our control- and that maybe the only thing we do feel we can manage is our eating behaviors and the way we feel in our bodies.” This feeling results in a heightened vulnerability linked to most eating disorders.

Family support is a major factor in seeking treatment and in the ability to continue treatment and the sustainability of recovery, Ahmadian says. She has many clients who don’t have family support, but she says that if clients can access recovery communities that are life-affirming and accepting, their chance at long-term success rises. Ahmadian says that she is passionate about helping people find faith in themselves to address their eating disorders. “The greatest effort that healthcare can provide is to be humanizing. When people feel cared for, when they feel their lived-experience validated, they in turn respond to treatment with more efficacy, higher motivation, faith, and with newfound hope.”

Across the country, many people go to their family practitioner seeking mental health help for their eating disorder. In Memphis, Fairhaven Treatment Center serves the needs of women, including trans- women. Fairhaven is accredited by Commission on Accreditation of Rehabilitation Facilities (CARF) and specializes in treating eating disorders by dealing with the trauma attached to the disorder.

Because there is little LGBTQ- friendly research across the spectrum in scientific journals, you’re almost negating the lived experiences of LGBTQ persons, Ahmadian says. Due to this, we are not placing an emphasis upon building culturally competent providers that have the toolkits and educational resources to directly impact those populations.

“If your clinician isn’t familiar with LGBT populations and you identify as an LGBT person, your lived experiences and stressors might vary greatly alongside your cis-normative or heterosexual counterpart. Not having clinicians who can/have sought access to this data to again recognize the specific anxieties found in this population and develop a deliberately empathic and inclusive treatment response is inherently problematic. Put simply, the mental healthcare of LGBTQ persons needs more attention.”

While Fairhaven only works with those who identify as a female, they work to guide anyone in the direction towards mental health help by suggesting the right provider for the client. They also accept most major insurance providers and will help find a financial solution if needed. OUT Memphis is another excellent resource to find a variety of care providers for both mental health and medical services. In addition to their brick and mortar presence at 892 South Cooper Street, OUT Memphis’s publishes the Trans Best of Memphis which lists LGBTQ-friendly providers. That link to the guide can be found here- outmemphis.org/programs- services/transgender/

Fairhaven Treatment Center
671 N Ericson Road
Cordova, TN 38018
844.757.7979
fairhaventc.com