Improving Health Outcomes for the Under-represented with Eating Disorders means looking beyond symptoms alone and understanding the person behind them. In his session at the Treating and Tackling Eating Disorders Conference, Dr Chukwuemeka Nwuba makes a clear and practical case for more inclusive, culturally aware and community-connected eating disorder care.
The session, now available to watch On Demand through the Treating and Tackling Eating Disorders Conference On Demand, focuses on how services can better recognise the needs of minoritised and under-represented groups. Drawing on his clinical work, community engagement and lived experience-led insights, Dr Nwuba highlights a central message: before clinicians can provide effective care, they must first understand who the individual is.
Starting with Safety: Understanding Identity Before Treatment
Dr Nwuba opens with a powerful lived experience quote: “Seeing and understanding an individual’s unique intersectional identity is imperative for safety building.” This idea shapes the whole session. For many people with eating disorders, particularly those from under-represented communities, feeling seen and understood may need to come before discussions about treatment tasks such as challenging fear foods.
This is not about delaying care. It is about making care safer, more relevant and more likely to engage the person receiving support. Eating disorders do not exist in isolation. They are experienced within families, cultures, faith communities, financial realities, gender identities, body expectations and personal histories.
Improving Health Outcomes for the Under-represented with Eating Disorders Through Intersectional Care
A major theme of the session is intersectionality. Dr Nwuba explains that clinicians and services need to ask better questions and notice the factors that are often missed. These include cultural background, ethnicity, religious beliefs, gender, sexuality, neurodivergent traits, disability, life stage, economic status and body size.
He also challenges the narrow stereotype that eating disorders only affect people who are visibly underweight. In practice, eating disorders can affect people in bodies of many different sizes. If clinicians rely too heavily on appearance, important warning signs can be missed, particularly in people in larger bodies or those whose distress is hidden behind social confidence, achievement or code-switching.
The “BITE SIZE” Approach to Better Assessment
Through Club Majority, Dr Nwuba and colleagues have developed practical tools to support clinicians, including a memorable “BITE SIZE” framework. It encourages professionals to consider factors such as background, identity, traits, timelines, economic status and size when someone presents with food or body image concerns.
This kind of tool matters because busy frontline settings, including primary care, can easily miss the wider context. A person’s eating pattern may be shaped by cost-of-living pressures, cultural food practices, religious observance, menopause, adolescence, neurodivergence or stigma around seeking mental health support. Without asking, clinicians may not know.
9% of 20- to 25-year-olds and 6% of 11- to 16-year-olds were identified as having an eating disorder in 2023 (NHS, 2023). This highlights just how many young people are dealing with this issue. Ensuring that schools and universities are prepared to deal with eating disorders and other mental health challenges is essential to ensuring consistent and quality care can be delivered when needed. That’s why we’re hosting The Student Mental Health and Wellbeing Conference 2026 this September. Examine the latest government initiatives tackling the rising challenge of student mental health and explores the obstacles faced by service providers in this online event.
Why Community Matters in Eating Disorder Support
Another important point in Dr Nwuba’s talk is that many people with eating disorders never present to specialist services. Some may not meet a diagnostic threshold yet but are still struggling. Others may meet that threshold but face barriers to access, trust, recognition or referral.
Dr Nwuba pushes back against the phrase “hard-to-reach communities.” His view is simple: many communities are not hard to reach; services need to go where people already are. That could mean schools, churches, mosques, barbershops, youth groups, cultural organisations or grassroots community spaces.
Lessons from Community-Based Projects
The session highlights several areas of Club Majority’s work, including collaboration with academic, clinical and community partners. One example discussed is work with the Maudsley Centre for Child and Adolescent Eating Disorders, exploring disordered eating and service access among young people from West African and Caribbean communities.
Feedback from community partners revealed practical issues: referral pathways were not always clear to teachers, youth workers or even clinicians. Young people also expressed a preference for support that felt community-based rather than overtly clinical. This has major implications for how services design outreach, build trust and make early help more accessible.
Bridging the Gap Between Research and Frontline Practice
Dr Nwuba notes that while valuable research exists in the eating disorder field, it does not always reach the people delivering care day to day. One of Club Majority’s key priorities is creating “actionable insights” — practical, usable learning that can support clinicians, families, educators and communities.
This includes work on medical education, resources for community organisations and educational videos designed to improve understanding of eating disorders. Dr Nwuba also discusses the importance of lived experience stories, referencing the book Eating Disorders Don’t Discriminate, which shares personal accounts that challenge assumptions about who develops eating disorders and what recovery journeys can look like.
What Services Can Take From Dr Nwuba’s Session
For healthcare professionals, educators and commissioners, the session offers several practical takeaways:
- Ask about identity early. Culture, faith, gender, sexuality, disability, neurodivergence and family context may all shape how an eating disorder presents.
- Do not rely on body size. Eating disorders can affect people across the weight spectrum.
- Make referral pathways clearer. Teachers, youth workers and primary care clinicians need straightforward guidance on what to do when concerns arise.
- Work with communities, not around them. Trusted spaces and grassroots organisations can play a vital role in engagement.
- Value lived experience. Personal stories can reveal barriers and needs that standard clinical models may overlook.
Conclusion: Improving Health Outcomes for the Under-represented with Eating Disorders Starts with Listening
Improving Health Outcomes for the Under-represented with Eating Disorders requires more than expanding existing services. It requires services to become more curious, more culturally informed and more willing to meet people where they are. Dr Chukwuemeka Nwuba’s session reminds us that effective treatment begins with recognition: understanding a person’s identity, context and community before deciding what support should look like.
For professionals working in eating disorder care, education, primary care or community support, this session offers a thoughtful and practical framework for improving access and outcomes. To explore the full discussion, watch the Treating and Tackling Eating Disorders Conference On Demand. Don’t forget to have a look at our upcoming Student Mental Health and Wellbeing Conference. It’s building up to be one of our most impactful and important events of the year.