Individuals living with physical or intellectual disabilities often face ableism, a societal bias that views people with disabilities as different and inferior to people without disabilities and often results in their needs being erased or ignored. Individuals with disabilities make up 12.6 percent of the American population, but they are incredibly underrepresented in popular culture and mainstream media. Only about 2 percent of television and film characters have a disability, and most of these characters are played by non-disabled actors, meaning that people with disabilities almost never see themselves represented. Instead, the media tends to favor tall, thin, able-bodied individuals, an appearance ideal that is impossible for many individuals with disabilities to achieve.
Given the number of individuals who live with some kind of disability, there is an astonishing lack of research on the intersection of disability and eating disorders. However, the limited research available does indicate that certain sections of the disability community are disproportionately affected by eating disorders. One study showed that no matter how long they had been living with the disability, individuals who self-reported a “severe” physical disability experienced greater body dissatisfaction than those who reported “mild” or “moderate” disabilities. Individuals with eating disorders who also had visual impairments reported increased body image issues, likely due to only being able to perceive their bodies through touch or comments from others. Other studies indicated that some people with physical disabilities turn to eating disorders as a way to compensate for their disability or feel a sense of achievement.
Individuals with intellectual disabilities also face eating challenges that can have life-threatening consequences. Around one-third of people with an intellectual disability also have issues with feeding, chewing, sucking, or swallowing. This can result in poor growth and nutritional deficiencies. In addition, some studies estimate that as much as 20 percent of individuals with eating disorders have co-occurring autism spectrum disorder (ASD). Individuals with ASD often exhibit strong systematic tendencies that are often inflexible and rule oriented. These traits may manifest themselves in the obsessive management of food intake, leaving individuals with ASD vulnerable to anorexia, binge eating disorder, and avoidant/restrictive food intake disorder.
While research shows that individuals with disabilities are just as likely to experience pressures related to body image and develop eating disorders as their able-bodied counterparts, they are not as likely to receive treatment. Part of this is likely due to the lack of specialists who have expertise in both eating disorders and physical or intellectual disabilities. Another barrier to treatment is the cost. Individuals with disabilities already spend more on self-care and medical expenses than individuals without disabilities, so adding another expense is not always an option. People with disabilities are overrepresented in low socioeconomic brackets, and they may not have adequate health insurance to cover the hefty cost of treatment. Individuals with disabilities may also be unable to receive treatment in a traditional way, although an increase in telehealth options is making some of these services more accessible. Eating disorders can affect anyone, and it is important for treatment specialists to be flexible and educate themselves on the needs of clients with disabilities in order to provide everyone with equitable access to the best care possible.
Individuals who are not healthcare providers can still help. Pay attention to diversity in advertising, film, and television, and support those who are inclusive of individuals with disabilities. Also, take the time to educate yourself, not only about eating disorders, but also the uniqueness of different disabilities and how they may impact someone’s body image. For further discussion on body image and the “appearance ideal,” consider participating in The Body Project or More Than Muscles programs offered through Student Counseling Services. For more information, visit https://www.nationaleatingdisorders.org/disability-community.