This year at #ASCA2025, I submitted a proposal focused on how school counselors can better support marginalized students who are struggling with eating disorders, and it was accepted! On the eve of my presentation, I wanted to share an overview of this information with school counselors. I hope you are able to gather some helpful information to take back to your schools.
When you think of the word eating disorders, what image comes to mind? For many educators, the stereotype of a thin, wealthy, white, cisgender girl pops up in their minds. But this narrow perception really overlooks the reality playing out in schools across the country—eating disorders affect students of all backgrounds (and I mean all backgrounds!). As school counselors, we must be prepared to recognize and respond to disordered eating in students from marginalized communities, where these disorders are often underdiagnosed, undertreated, and misunderstood. So, why the big deal? Let me share the hidden dangers.
The Hidden Crisis
Every 52 minutes, someone dies as a result of an eating disorder (this is not an exaggeration). With the second highest mortality rate of all mental health conditions, eating disorders are a serious public health concern. Yet, marginalized groups—including Black, Brown, Indigenous, Asian, LGBTQIA+, and male students—often go unnoticed in schools.
Why? Because eating disorders in these populations frequently don’t match the stereotype. A Latinx student who skips meals to afford food for younger siblings, or a Black teen boy obsessively working out and restricting calories to achieve a “cut” physique, may not raise red flags in the same way a visibly underweight white girl might. But the risks—and the suffering—are just as real.
Understanding the Root Causes
So, what causes an eating disorder? Eating disorders are not about food—they are about genetics, emotion, trauma, and control. And in marginalized populations, they are deeply connected with:
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Discrimination and cultural body norms
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Sexual and physical trauma
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Poverty and food insecurity
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Gender dysphoria and internalized stigma
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Social media-fueled body image pressures
Students in these groups may also face fatphobia, weight discrimination, or cultural silence around mental health, further complicating their willingness to seek help.
What School Counselors Can Do
1. Challenge Bias and Stereotypes
Eating disorders affect all genders, body sizes, races, and cultural identities. We need to acknowledge this openly and often in our practice. Ensure that your screening, prevention efforts, and counseling services reflect this understanding. This may include educating administrators that weight loss challenges or an emphasis on body size are not a healthy practice—even if they have been commonly accepted or previously participated in.
2. Implement Trauma-Informed, Culturally Responsive Programs
Another idea is to consider partnering with a health educator and community leaders to develop prevention programs that are mindful of diverse cultural norms. Avoid messaging that equates thinness with health. These messages according to NEDA and the Renfrew Center should promote size acceptance, mindfulness and body neutrality over dieting and weight loss.
3. Use Inclusive Screening Tools
Tools like the SCOFF Questionnaire can be useful, but they must be accompanied by a broader, more culturally aware approach. For example, ask questions like, “Do you ever skip meals because of stress or financial strain?” or “Do you feel pressure to look a certain way because of your gender identity or cultural background?”
4. Support Students Through Tiered Interventions
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Tier 1: Classroom guidance promoting body positivity, media literacy, and emotional wellness. When presenting to students, it is important to follow the suggested presentation guidelines provided by NEDA.
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Tier 2: Small groups for students struggling with body image, anxiety, or stress-related eating patterns.
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Tier 3: Individual counseling with referrals to culturally competent treatment providers when necessary.
5. Address Stigma Head-On
Create safe spaces for students to talk about their struggles without shame. Be mindful of gender dynamics in group settings and allow anonymous participation in discussions. Educate the wider school community—including teachers and parents—on how bias and diet culture harm students.
Moving Forward with Compassion and Clarity
The work of a school counselor is often quiet, unseen—yet profoundly life-changing. When we advocate for our most marginalized students, we rewrite the script on who deserves care, who gets to heal, and who gets to thrive.
Resources for Counselors:
Connect Cynthia Morton at mortoncynthia@gmail.com.
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