The Quiet Barriers to Eating Disorder Support
Laura Menendez
We’ve made progress in how we talk about bodies. Messages of acceptance and respect are more visible than they once were, and that shift matters. But there’s a conversation that still lags behind: how deeply our assumptions about bodies shape who is recognized as struggling—and who is not.
As a teenager, I rarely saw eating disorders portrayed in ways that reflected my experience. The narratives I encountered—through media, education, and even healthcare—followed a familiar pattern, and I didn’t fit it. Without language or representation that mirrored my reality, it took years to recognize that what I was experiencing was disordered, and even longer to believe it warranted care.
Eating disorders exist across all body sizes, identities, and lived experiences. Yet weight is still often treated as a stand-in for health, severity, or eligibility for support. These assumptions don’t just influence public understanding—they quietly shape clinical encounters, access to treatment, and the way individuals experience care once they finally walk through the door.
Growing Up with the Wrong Tools
As a teenager in a larger body, conversations about food, movement, and health were rarely neutral. Exercise was framed as something to fix my body. Nutrition was explained in terms of control and reduction. Movement was prescribed with an outcome already attached: weight loss.
What was missing was balance.
No one talked to me about how food could support my brain, my energy, or my ability to focus and rest. Movement wasn’t introduced as something that could help with stress, sleep, or emotional regulation. These tools weren’t offered as options in a toolbox for overall well-being—they were framed as obligations tied to changing my body.
Over time, that framing matters. When care focuses on altering appearance rather than supporting function and resilience, it can quietly reinforce the belief that your body is the problem to be solved. For many adolescents, that belief becomes fertile ground for disordered eating, shame, and a fractured relationship with self.
First Experience with Treatment
At 18, I chose to seek treatment. At the intake appointment, I carried uncertainty—unsure of how I would be received or what would follow after I shared my experiences.
Before the assessment even began, I was asked to change into a paper gown for a blind weight. This is a routine part of many intake processes, something designed with neutrality and clinical efficiency in mind.
But the gown didn’t fit my body.
It tore as I put it on. I got dressed again, stepped into the hallway, and asked for another. I was given multiple gowns and pieced them together as best I could before walking across the hallway to be weighed.
In that moment, the clinical process overshadowed the human one.
I felt exposed. Embarrassed. Out of place. Before I ever spoke about my relationship with food or my internal world, I had already absorbed a message: this space wasn’t designed with my body in mind.
I completed the assessment. But I also knew, before it ended, that I wouldn’t return. My decision had less to do with the clinicians themselves and more to do with what my body experienced before my voice was ever heard.
Why Experience Matters—Even as Care Evolves
This isn’t about blaming treatment programs or dismissing how far eating disorder care has come. Weight-inclusive approaches, trauma-informed care, and ongoing research have meaningfully shifted the field. Many providers are doing thoughtful, intentional work to improve access and outcomes.
And still—individual experiences matter.
Progress doesn’t erase the impact of moments where systems unintentionally reinforce exclusion. For adolescents especially, early interactions with care can shape whether they seek help again or decide they don’t belong in treatment at all.
Body Image, Shame, and the Long Road to Respect
Body dissatisfaction often isn’t about vanity—it’s about safety, worth, and belonging. When someone becomes preoccupied with changing their body, it can fuel rigid behaviors around food and movement, followed by cycles of guilt, disappointment, and shame when those efforts fail to deliver peace.
Healing body image isn’t about loving how you look every day. It’s about shifting from shame to respect. That shift doesn’t happen overnight. In eating disorder recovery, it often comes after the body has been stabilized, patterns have been challenged, and safer behaviors have had time to take root.
We live in a world saturated with messaging—through media, social platforms, and constant comparison—that equates worth with size. Adolescents absorb these messages early, and they don’t disappear just because someone enters treatment.
Effective care goes beyond symptom management by addressing real-life context and underlying conditions, while supporting the individual’s biological, emotional, social, and physical needs.
Where Gaps Still Exist
Many individuals seeking support find themselves navigating care systems that weren’t designed with enough flexibility to meet them where they are. Needs don’t always align cleanly with predefined pathways, and when that happens, people can feel like they have to adapt themselves to the system—rather than the system adapting to them.
Effective care recognizes individual differences and responds to personal history, readiness for change, identity, and real-life circumstances. Honoring individuality in treatment increases the likelihood and sustainability of recovery.
Support also extends beyond structured appointments and prescribed interventions. Individuals often need room to explore what healing means for them, while those around them may benefit from education, coaching, and shared language to offer support in ways that feel grounded rather than reactive. Recovery rarely happens in isolation—it takes shape within environments and systems that are willing to listen, adapt, and respond with intention.
Why Weight-Inclusive Care Is Essential
Weight-inclusive care isn’t about ignoring health. It’s about refusing to use body size as a proxy for worth, motivation, or diagnosis. It’s about designing systems that don’t unintentionally exclude the very people they aim to help.
Treatment environments that prioritize inclusion send a clear message: you belong and are welcome. This fosters trust and encourages individuals to seek support.
And for someone walking into an appointment for the first time, that message can make all the difference.
Making Space for What Comes Next
For individuals navigating an eating disorder or disordered eating, support doesn’t have to look one specific way. There are pathways that prioritize alignment—care that considers both clinical needs and personal experience, and that allows room for choice, pacing, and dignity throughout the process.
For families and loved ones, support can also mean learning how to be present without pressure, how to communicate without fear of saying the wrong thing, and how to understand their role in a way that feels steady rather than overwhelming. Guidance, shared language, and education can help shift uncertainty into connection.
If you or someone you love is struggling with an eating disorder, disordered eating, or body image concerns, know that support exists—and that it can be tailored, collaborative, and respectful of the whole person. Intent Clinical works alongside individuals and families to help clarify next steps and identify care that feels supportive, appropriate, and sustainable.
