Session Title:

Eating Disorders in Our Tribal Communities? Considering Minority Stress, Trauma and Risk Factors to Start the Conversation

Date- April 20 3:00-3:45 PM CT



Eating disorders are complex mental health issues of disconnection, surrounded by shame, serving as maladaptive coping mechanisms by offering a facade of power and control. Eating disorders impact sense of self, close relationships, and community surrounding those struggling. Eating disorders do not discriminate: These disorders are prevalent or more common across racial and ethnic, gender, and sexual minorities, among other marginalized communities. Eating disorders also commonly co-occur with substance and other mental health diagnoses, medical complications, and suicidality, contributing to treatment complexity and high lethality.

Minority stress has received increasing attention over the last year, notably its impact on mental health and risk. Research shows that minority stress and experiences of discrimination may contribute to eating disorders. For example, among African Americans, experiencing racism and discrimination increases the odds of struggling with Binge Eating Disorder (BED) (Assari, 2018). Some, albeit scant, research suggests that emotional distress and racism-related stress are associated with binge eating among American Indians (Clark & Winterowd, 2012). Trauma is also associated with eating disturbances. Disordered behaviors may perpetuate cycles of suffering through violent consumption, elimination, and exercise.

Treating eating disorders creates adaptive avenues for releasing and healing from the emotional pain fueling these behaviors. The limited research and discussion about eating disorders within tribal communities begs the question: Are our tribal communities struggling with this highly lethal mental illness? What impacts detecting these struggles? How can we provide high-quality treatments that are culturally sensitive to the values, strengths, and stressors impacting our diverse tribal communities?



Ashley Acle, MFT, MBA, LMFT is a clinical quality leader, mental health advocate, and consultant. Her research interests include eating disorders and mental health treatments in marginalized communities, integrating emotional expression and contextual factors. She recently co-authored a systematic review on Cultural Considerations in the Treatment of Eating Disorders among Racial/Ethnic Minorities (Acle et al., 2021). Ashley is passionate about high-quality, culturally sensitive care and addressing mental health treatment disparities with technology.  She enjoys writing and speaking about mental health and eating disorders in underserved communities, using education to start dialogues and challenge shame and stigma. She has led clinical quality initiatives and served in operational roles as Regional Compliance Manager, Director of Clinical Services, and Program Director.

Ashley completed her Bachelor’s degree at Swarthmore College and her Master of Family Therapy at Drexel University. She is a Clinical Fellow with the American Association of Family Therapy and a Clinical Member with the California Association of Marriage and Family Therapists (CAMFT). She serves on several professional committees and organizations, including the African American Eating Disorder Professionals and Black, Indigenous, People of Color (AAEDP-BIPOC) Committee of the International Association of Eating Disorder Professionals (iaedp), and the Academy for Eating Disorders (AED).

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