How do you explore a client’s cultural background, food traditions, and identity during an initial appointment?
We actually begin exploring a client’s cultural background and food traditions even before the first session, through our intake forms. We ask about cultural, religious, or family food traditions they honor and how important those are in their life. Then in the initial and follow-up sessions, we stay curious by asking open-ended questions about how they connect (or don’t connect) with those traditions. Even if someone shares, for example, that they’re Iranian, we don’t assume they follow a traditional Iranian diet. Instead, we invite them to share what feels authentic and meaningful to them and how that intersects with their relationship to food.
Can you share an example of modifying traditional or religious meals (e.g., halal, kosher, fasting practices) to support recovery from an eating disorder?
When supporting someone in recovery, we always aim to honor their cultural and religious food practices as part of the healing process. For example, if a client is halal, we’ll make sure their meal plan includes halal proteins and culturally familiar dishes. If someone participates in religious fasting, we might explore with them and their treatment team ways they can safely fast or alternative ways to observe their faith while maintaining medical stability. The goal is to integrate these traditions into recovery, rather than viewing them as barriers.
How can eating disorders and body image present differently in underrepresented groups?
Eating disorders often look different outside the stereotype of a thin, young, white woman. For clients in underrepresented groups, body image concerns might center around things like skin color, hair texture, body hair, or cultural beauty ideals – not just body weight or shape. Food beliefs and behaviors may also be shaped by family history or systemic oppression. This is why we avoid assumptions and instead listen deeply to each client’s lived experience so our care reflects their reality.
When patients feel their culture or traditions were overlooked by a previous provider, they may experience “clinician trauma.” How often do you meet a new patient carrying that type of experience and how do you work to rebuild trust and ensure they feel understood?
I do meet clients who’ve felt unseen or dismissed by previous providers, especially when their cultural foods didn’t “fit” meal plans or were labeled “unhealthy.” This can understandably create mistrust with clinicians. To rebuild trust, I approach with curiosity rather than assumption and ask questions about which traditions feel important to keep. We explore together how cultural foods can be integrated meaningfully into recovery so clients feel respected.
How can RDs address their own biases in order to work with clients from underrepresented backgrounds?
Start by actively learning: read books, attend webinars/presentations, or listen to podcasts by people whose lived experiences differ from your own. But don’t stop there – seek supervision or consultation from more experienced clinicians, especially those whose identities are closer to the communities you serve. Supervision helps you unpack unconscious biases and see systemic factors that might be missed from your vantage point. It’s an ongoing process of reflection, humility, and commitment to learning.
Where did you learn effective skills to provide inclusive eating disorder care?
My own lived experience as an Iranian-American shaped how I see food and identity and definitely influences my work. Additionally, I’ve learned a lot from mentors/supervisors and through ongoing education: webinars, conferences, and books by authors whose lived experiences differ from mine. A few resources I recommend:
- EDRD Pro – offers regular webinars and case consultation centering weight-inclusive, culturally-affirming care
- Fearing the Black Body by Sabrina Strings
- Hunger: A Memoir of (My) Body by Roxane Gay
- You Just Need to Lose Weight (and 19 Other Myths About Fat People) by Aubrey Gordon
- The Latina Anti-Diet by Dalina Soto
- Diabetes Digital podcast
- So We’ve Been Told podcast (not ED specific)
- Nourishing Neurodivergence podcast
How can the next generation of RDs help break the stereotypes surrounding eating disorders?
It starts with naming and challenging the stereotype that eating disorders only affect thin, young, white women. The reality is people of all body sizes, genders, races, and backgrounds experience eating disorders. The next generation of RDs can keep this message alive by screening everyone (regardless of appearance), sharing diverse stories, and refusing to make assumptions based on looks. Instead, ask each client about their lived experience and relationship with food and body. That’s how we build truly inclusive, effective care.
