By Holly Simpson
Culture & Religion
An individual’s cultural and religious identity plays a core role in shaping food choices, patterns and beliefs. Dietetic assessments that explore cultural and religious food practices, as well as family traditions, support more collaborative and sustainable interventions. Developing culturally relevant meal plans ensures that unique and tailored advice is provided, helping to improve engagement and acceptance of treatment.
Within treatment centres such as Orri, offering diverse menus and honouring religious holidays such as Hanukkah, Christmas, Diwali and Eid al-Fitr, as well as empowering clients to share family recipes, can support individuals to feel represented and build connection and identity around food in recovery. Dietitians, alongside our chef Esme, have a key role in embedding this into service delivery.
Economics
Access to adequate nutrition should be available to everyone, regardless of income. Understanding a client’s economic circumstances helps ensure that their dietetic plan is achievable and sustainable. Dietetic care should explore factors including access to kitchen appliances, proximity to supermarkets, budget constraints and reliance on food banks, whilst maintaining nutritional adequacy.
Gender
Underrepresentation of men in eating disorder services remains an issue, with limited research into male experiences. Societal norms around masculinity perpetuate stereotypes that inhibit men from seeking help, impacting diagnosis and public awareness. Eating disorders are often perceived as a “female disorder,” which can perpetuate stigma and shame for men and gender-diverse individuals.
Dietitians can play a role in exploring and challenging gender narratives around food, body image and exercise, including muscle dysmorphia and excessive exercise, whilst creating a space where all genders feel seen and validated. Gender-affirming care is also essential, where understanding the nutritional changes hormone therapy (HRT) can have on appetite, body composition and energy requirements helps provide inclusive recovery pathways.
Body Size
Weight stigma remains a concern within healthcare, particularly in eating disorder services where BMI thresholds may determine access to treatment. This can exclude those in larger bodies from care and reinforce negative self-beliefs. A dietitian’s role is essential in delivering weight-neutral and inclusive approaches, focusing on healthy behaviours around food rather than body size alone. This includes exploring the meaning of health beyond weight, factoring in social and mental health determinants, and using respectful, non-stigmatising language.
Neurodiversity and Adaptations
There is a strong overlap between neurodiversity and eating disorders; however, care may not always be adequately adapted to meet the needs of neurodivergent individuals. Individuals with neurodiversity may experience differences in interoception, including the ability to connect with hunger and fullness cues, as well as sensory sensitivities.
From an intersectional perspective, dietitians play a key role in adapting nutritional care to fit the individual rather than expecting the individual to conform to rigid service structures. This can include establishing regularity around eating whilst accounting for necessary sensory adaptations to meals, including texture, temperature, flavour and familiarity. Environmental changes should also be considered, such as calm spaces, adjusted lighting, reduced noise levels and amended seating arrangements, all of which can promote accessibility and meaningful engagement.
Disability and Accessibility
Disability intersects with eating disorder care in complex and multifaceted ways, shaping individuals’ access to services, mobility, energy levels, fatigue and functional capacity around eating and food preparation. Dietitians therefore play a crucial role in adapting care to ensure inclusivity and accessibility.
This includes considering the accessibility of dining environments, the need for adaptive equipment, individuals’ ability to prepare meals independently, and the importance of energy conservation within nutrition goals.
Conclusion
An intersectional approach to eating disorder dietetics provides a lens through which clinicians can better understand their clients, seeing beyond the eating disorder alone and recognising the complex interplay of social, cultural and structural contexts at play. By recognising how these factors impact nutritional experiences, clinicians can support more ethical, inclusive and sustainable care within the industry.
Considering intersectionality within dietetics as a profession is equally important. The profession remains predominantly represented by white females, with 81% identifying as white, whilst only 6% of dietitians are male, 6% identify as disabled and 3% as LGBTQ+.
As clinicians, acknowledging and reflecting on our own positions, privileges and professional histories is necessary to challenge dominant Western normative expectations around food and idealised body types.
If you’re feeling stuck, you are not alone. And if you’re asking difficult questions, that doesn’t mean you’re going backwards, it often means you’re beginning to look at yourself with honesty and care.
We’re here to help
If you or someone you care about is struggling, get in touch with Orri’s team. We’re here to listen, advise, and offer a safe space for recovery.
