Eating disorder science challenged to move beyond its Eurocentric roots

Researchers say culturally narrow assumptions are leaving minoritised people underdiagnosed and underserved, and call for measures and treatments built around diverse lived experiences.

Eating disorder research has long been built on a narrow set of assumptions, and a new editorial in Frontiers in Psychiatry argues that those limits are now impossible to ignore. Jennifer Jordan of the University of Otago and Health New Zealand – Canterbury, Gloria Fraser of Te Herenga Waka – Victoria University of Wellington, and Eva M. Trujillo Chi Vacuán of Comenzar de Nuevo A.C. and Tecnológico de Monterrey say the field has been shaped too heavily by Eurocentric, White, cisgender and heterosexual perspectives. That imbalance, they argue, has left major gaps in how eating disorders are recognised, studied and treated in minoritised communities.

The editorial says the problem is not simply one of representation in research samples. It points to a wider pattern in which minoritised groups are less likely to be identified correctly, less likely to enter treatment and more likely to drop out once they do. A related analysis published in Current Psychiatry Reports describes these barriers in racial and ethnic minority populations and calls for interventions that reflect cultural values, healing traditions and lived experience. Research on US college students published in Social Science & Medicine similarly found that transgender and non-binary people face especially high diagnostic risk, while racial and ethnic minorities are less likely to receive an eating disorder diagnosis at all.

To test whether current models travel well across cultures, the special topic gathered 13 papers from the Middle East, Australasia, Latin America, the US, Italy and China. The spread itself is part of the argument: the old idea that eating disorders are mainly Western conditions is looking increasingly untenable. The editors note that growing reports of body dissatisfaction and eating disorder symptoms in diverse regions challenge that view, even as important evidence gaps remain. A scoping review of minority ethnic populations in Australia, Canada, Aotearoa New Zealand and the UK reached a similar conclusion, finding that these groups remain under-represented in the literature and that culturally sensitive approaches are still lacking.

Several studies in the collection examine whether the tools used in the field are fit for purpose. One paper extends a skin-tone trauma framework to suggest a pathway between colourism and eating disorder risk among Black, Indigenous and other people of colour. Another review of Indigenous communities in Latin America found a complex negotiation between traditional and Western beauty ideals, while also questioning whether existing body-image measures can capture those experiences accurately. In the Middle East, researchers reported gender differences in how social beauty norms are experienced in Saudi Arabia, while work in Jordan found elevated eating disorder risk among medical students, particularly women. A separate psychometric study across Gulf Cooperation Council countries offered preliminary support for a body-image assessment tool in the region, but also identified the need for further validation.

The special topic also includes research on transgender and gender-diverse people, prevention and treatment. In New Zealand, one study reported elevated eating disorder risk among trans people, especially younger participants and those who were Māori, neurodivergent, disabled or under material strain. In the US, a co-designed prevention programme called Body Justice was popular with students from marginalised identities, although early results varied across subgroups. In Mexico, researchers outlined the first pilot randomised trial of a culturally adapted body-image programme, which is designed to test feasibility before any full efficacy study. On the treatment side, work from New Zealand argues that Western eating disorder models can fall short for Māori patients and proposes combining specialist supportive clinical management with Rongoā Māori, the traditional healing system, to better reflect holistic views of wellbeing. In the United Arab Emirates, another team described adapting cognitive behavioural therapy enhanced to account for language, religion, modesty norms, family involvement and Ramadan fasting.

The editorial ends with a warning and a framework. The authors say many existing studies have adapted Eurocentric models for use in different cultural settings, but that adaptation should not be confused with interventions that originate from distinct worldviews. They propose a cultural responsiveness framework that separates culturally sensitive use of standard evidence-based models, adapted measures and therapies, and treatments developed from within a specific culture itself. The broader message is clear: if eating disorder science is to serve patients more equitably, it must widen both who it studies and how it defines health, distress and recovery.