'You Can Be Simultaneously Powerful and Marginalised at the Same Time in Different Ways'. An Intersectional Examination of Barriers and Facilitators of Help-Seeking for Eating Disorders by People From Under-Served Groups.

objectiveTo explore barriers and facilitators to help-seeking by people from under-served groups in eating disorders (EDs).

methodsSeventeen participants with lived experience of an ED, identifying as members of groups traditionally under-served in ED research (ethnic minority, sexual or gender minority, or men), took part in semi-structured interviews. Data were analysed using reflexive thematic analysis, with inductive coding, interpretive theme development, and deductive mapping onto a micro-, meso-, and macro-level intersectional framework.

resultsParticipants identified factors consistent with existing research on barriers and facilitators to help-seeking alongside factors unique to under-served groups. These included internalised stigma, stereotypes about EDs, lack of inclusive environments and poor representation in ED resources. Systemic factors comprised barriers to accessibility or strict inclusion criteria for specialist treatment. Facilitators to help-seeking included inclusive care, and the utility of information seeking online.

conclusionFindings extend existing evidence on ED help-seeking and offer novel insights into experiences of under-served groups in ED. To improve help-seeking among under-served groups, recommendations include interventions to address stigma, challenging stereotypes about EDs, and ensuring inclusive representation in psychoeducation and service provision. At a systemic level, reforms to service commissioning and inclusion criteria are necessary to create equitable access to care.