Breaking the Silence: Addressing Eating Disorder Stigma in Asian Communities
Youyou He is an Asian migrant with an academic background in cultural studies, sport and exercise science, and psychology. She is a passionate advocate for holistic health and wellbeing, with a particular interest in reducing mental health stigma and promoting culturally responsive care.
Is there still stigma around eating disorders in many Asian communities? If so, what does that stigma look like?
Yes. Mental health stigma remains prevalent in many Asian communities, and eating disorders are no exception. Stigma and mental health have a bidirectional relationship: public stigma can become internalised, leading individuals to develop negative beliefs about themselves, which may reinforce unhealthy behaviours and delay recovery.
Some common forms of stigma include:
- Mental health conditions being viewed as a sign of personal weakness, accompanied by fear of judgment and concerns about bringing shame to oneself or the family, which discourage people from seeking help;
- Emotional/psychological distress being more likely to be expressed or recognised as physical symptoms, making it more difficult to identify underlying mental health concerns and potentially contributing to maladaptive coping behaviours, including EDs.
- High family expectations and achievement pressure, particularly among 1.5- and 2-generation migrants. Pressure to excel academically and/or in competitive sports, where maintaining a particular weight category may be expected, can increase the risk of EDs.
What are the biggest barriers that prevent people from seeking help for an eating disorder, whether that’s cultural beliefs, language, family expectations, or something else?
There is no single barrier. It is usually a combination of factors, and every individual’s experience is different.
It is also important to recognise that “Asian” is an umbrella term encompassing highly diverse communities with different languages, cultures, migration experiences, and understandings of mental health. These diverse psychocultural identities mean that experience of stigma and help-seeking vary considerably across Asian communities.
Common barriers include mental health stigma, limited mental health literacy, language barriers, concerns about confidentiality within close-knit communities, family expectations, and uncertainty about how or where to access culturally appropriate support.
How do family expectations and cultural values influence someone’s experience of an eating disorder and their willingness to access treatment?
Family expectations and cultural values can have a significant influence. For example, when parents place strong expectations on children to succeed in competitive sports, young people may feel compelled to restrict their food intake to maintain a particular weight category if body weight is perceived as important for performance.
Similarly, in some Asian cultures, there is considerable emphasis on maintaining a slim body shape, particularly for women. These beauty ideals may encourage excessive dieting or restrictive eating, which can contribute to EDs and cycles of binge eating and relapse. At the same time, concerns about family reputation, fear of disappointing loved ones, and reluctance to discuss emotional difficulties may reduce a person’s willingness to seek treatment.
What can organisations like Recovered Living NZ do to make eating disorder services feel more culturally safe and welcoming for Asian communities?
While organisations have an important role to play, reducing stigma requires a collective, system-wide effort.
Services can become more culturally safe by improving cultural responsiveness, engaging with diverse Asian communities, providing language support where appropriate, increasing mental health literacy, and involving families when appropriate and desired by the individual. More broadly, creating an environment where mental health and EDs are understood without judgement requires collaboration across healthcare services, schools, community organisations, families, and the wider community.
What message would you like to share with someone in the Asian community who may be struggling with an eating disorder but feels too ashamed or afraid to reach out for help?
To the individual: Please don’t ignore that quiet inner voice telling you, “I need help,” even if it’s transient. Reaching out for support is a sign of courage, not weakness. There are health professionals who genuinely want to help you, and recovery is possible.
To parents and families: Be open to learning about mental health conditions. Encourage personal growth and wellbeing, and try to balance expectations with compassion, understanding, and emotional support.
To the wider community: Let’s work together to reduce stigma, foster understanding, and create communities where people feel safe to seek help. By supporting one another with empathy and cultural understanding, we can improve the holistic wellbeing of individuals, families, and communities.
