Binge Eating Disorder in Black and Caribbean Culture: Unseen, Under-diagnosed, Under-treated
When people imagine an eating disorder, a familiar image often comes to mind: extreme thinness, severe restriction, a white teenage girl. But for many women of color—Black, Caribbean, and Afro-descendant—another form of disordered eating is more common, less visible, and too often untreated: binge eating disorder.
This blog explores how binge eating affects women of color, the cultural, familial and trauma-related factors that increase risk, and why many go unseen. I’ll also share how an integrative, holistic psychiatric approach helps address the whole person—mind, body and spirit—to support healing emotional wounds and reclaim healthier connection with food, body, and self.
What is Binge Eating Disorder?
Binge eating disorder is characterized by binge episodes which are repeated episodes of consuming unusually large amounts of food in a discrete period of time, accompanied by a sense of loss of control over eating. Unlike bulimia nervosa, these episodes are not regularly followed by purging behaviours (vomiting, laxative use, compensatory exercise). While the DSM-5 acknowledges binge eating disorder (BED) as a diagnosis, the behaviors and suffering behind it far exceed diagnostic labels.
In women of color, symptoms can be masked by societal or cultural norms around size, body shape, food, and coping. The outward appearance of a larger body may not match expectations of someone with an “eating disorder,” which fuels under-recognition and under-treatment.
Prevalence and Patterns Among Women of Color
Emerging research shows that women of color may experience binge-eating behaviors at rates equal to or higher than their white peers—but have less access to diagnosis, treatment, or culturally-aware care.
For example, a review found Black women had some of the lowest rates of care access for BED, with fewer than 8 % of Black women with BED seeking treatment. (Historical reference: Goode, R.W., “A Review of Binge Eating Disorder in Black Women”, 2022)
Another study found that among Black Americans (including Afro-Caribbean women), those experiencing food insufficiency were more likely to report recurrent binge eating. (Reference: “Prevalence and contributing factors to recurrent binge eating …”, 2021)
Also, a recent article noted that Black women may have binge eating disorders at about 5 % compared with ~2.5 % among non-Hispanic white women. (Anderson, S. et al., “Binge Eating Disorders Among Black Women …”, 2023)
Importantly: The issue isn’t just prevalence—it’s how culture, family, identity, and trauma color the experience. For many women of color, food becomes a source of comfort, survival, connection, and identity—and disordered eating can be woven into that relational map.
What keeps Black and Caribbean women from seeking care for eating disorders?
Several interlinked factors contribute to the disparity:
1. Cultural norms and body ideals.
In many Black and Caribbean communities, larger or curvaceous body shapes may be celebrated as resilient, healthy or desirable, which can mask disordered eating behaviours. At the same time, internalised pressure to conform to thin-ideal norms (especially in majority-white spaces) may drive unseen distress. (See Chilson, A., “Body Image Ideals and Risk for Disordered Eating in Black American Women”, 2017)
2. Trauma, racism, stress & coping.
Women of color often face multiple layers of stress: racial discrimination, intergenerational trauma, cultural stress, family expectations. These stressors may lead to emotional dysregulation and food may become a way to soothe, distract, or self-protect. The conventional screening tools and treatment models frequently fail to incorporate these cultural and trauma-informed factors.
3. Food environment & socio-economic factors.
Research shows food insecurity and cyclic food availability (periods of scarcity followed by fullness) correlate with higher risk of binge eating among women of colour. (“Prevalence and contributing factors …”, 2021)
4. Under-diagnosis and treatment bias.
Healthcare providers may hold unconscious stereotypes about eating disorders (e.g., “anorexia = white, thin young woman”). Thus, women of color are less likely to be screened for BED, less likely to receive early intervention, and more likely to discontinue treatment. (“Eating disorder treatment stereotypes …”, 2023)
Integrative & Holistic Approach to Healing Emotional Wounds
In my practice at Combahee River Integrative Psychiatry, I champion a holistic approach—because healing binge eating in women of color isn’t just about food. It’s about culture, identity, body, mind, relationships, and care that honours your full self. Here’s how I frame that work:
Mind-Body Connection
We explore how your relationship with food is tied to your body’s sensations, your nervous system, your trauma history and your cultural background. Somatic awareness, mindful eating practices, and embodied psychotherapy (e.g., Gestalt, psychodynamic) become key interventions.
Psychotherapy + Culture
Working with modalities that attend to trauma, identity, family systems and culture (rather than simply behaviour change) is essential. Healing emotional wounds means naming what was carried, uncovering how coping patterns formed, and creating new relational and cultural scripts of care.
Medication + Lifestyle Support
When appropriate, medication or thoughtful pharmacological management may support regulation or comorbid conditions. But this is paired with lifestyle work: nutrition, movement, sleep, community connection—especially as they apply within Black and Caribbean cultural contexts.
Relational & Family Systems
Because binge eating in many of our clients ties to family stress, intergenerational trauma, migration or identity pressures, we often work relationally—using individual and sometimes family-system interventions, community resources and culturally-responsive support groups.
Cultural Affirmation & Community Healing
Healing isn’t about assimilation—it’s about affirmation. We honor cultural foodways, reclaim language around food and body, challenge stigma in the community, and create spaces of belonging and care.
How to Take the First Step
If you’re a woman of color experiencing binge eating, feeling unseen or stuck, here are small actionable steps:
Notice your body’s hunger and satiety cues. Binge eating episodes are commonly preceded by under-eating or starved physical states. Eating to meet your body’s nutritional needs decreases the urge or compulsion to binge in the evenings or late nights.
Begin small: one mindful meal, one check-in with your body, one kind question to yourself: “What do I need right now that isn’t food?”. A great place to start is eating a breakfast that is rich in protein and fiber to sustain your body during the busiest part of your day.
Notice the “when” and “why” of your binge episodes: Are you eating in response to emotional hunger, stress, racial trauma, family conflict, loneliness?
Ask yourself: What feelings am I trying to soothe? And what would I rather feel?
Seek care from a provider who understands culture, trauma and integrative care (like this practice!)—because you deserve to be seen and supported.
Connect with a community of peers who share your identity and journey—because you are not alone. (Add link to ANAD support groups- highlight they have a Binge Eating Disorder group Thursdays at 7 pm ET and BIPOC group Mondays at 8 pm ET (https://anad.org/get-help/about-our-support-groups/)
Closing Thoughts
Know that you are not alone and you don’t have to suffer in silence. Binge eating in Black and Caribbean women is not rare—it is often unspoken, misdiagnosed, dismissed. Yet it is deeply real—and it matters. When disordered eating happens at the intersection of identity, culture, trauma, and body, the healing path must be broader than “just stop eating this” or “work out more.”
At Combahee River Integrative Psychiatry, we believe your path to healing emotional wounds can be guided by culture-informed care, collaboration, and whole-person healing. You are worthy of care that sees you—your history, your identity, your body, your story. And you are capable of transformation.
Let’s walk this journey of healing—with intention, compassion, and freedom.
