Priority populations are central to PHNs’ strategic focus because targeted support and service delivery can make a significant difference in improving equity, access, and health outcomes. NEDC is committed to providing information and resources about to support prevention, identification, response, treatment and recovery from eating disorders for the diverse members of Australia’s population.
First Nations peoples
There is a substantial research and evidence gap regarding eating disorders and First Nations peoples, which has a flow-on effect to policy and practice, where practical guidance on responding to eating disorders in First Nations people and providing culturally aligned care is very limited (Gall et al, 2025). Experiences such as body shame and food worries can be prevalent in communities. These experiences are compounded by a range of factors which uniquely and/or disproportionately affect First Nations peoples in Australia, including the ongoing impacts of colonisation, intergenerational trauma, food insecurity, lack of access to culturally safe healthcare, and exposure to both racism and weight stigma.
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In a 2020 study 27% of First Australian survey respondents had an eating disorder (Burt et al., 2020).
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First Australians with an eating disorder had higher levels of weight/shape overvaluation, were younger and had poorer mental health quality of life (Burt et al., 2020).
Ensuring access to culturally safe and valid approaches to eating disorder care, culturally aligned service planning and health promotion approaches which centre social and emotional wellbeing and cultural strengths as protective factors are crucial steps for a PHN to take in collaboration with community.
Resources
WellMob resources when available
For further information on how your PHN can support better responses to eating disorders with First Nations communities, contact info@nedc.com.au
Culturally and linguistically diverse people
People from culturally and linguistically diverse (CALD) communities and people who are culturally and racially marginalised (CARM), communities often face additional barriers in identification, responses, and treatment for eating disorders. These can include stigma, limited access to culturally safe services, language and communication differences, differences in the ways that health and health behaviours are conceptualised, and underrepresentation in health messaging and clinical research.
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Studies in the USA and UK both show higher prevalence of eating disorders occurring in the black, Indigenous, Hispanic, Asian and African-Caribbean immigrant populations (Nasser, 2006).
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Cultural background has a significant impact on attitudes towards food, such as weight concern, food negativity and the link between diet and health (Rodriguez-Arauz et al., 2016).
For effective and equitable care, it's essential to understand how different cultural norms around body image, food practices, and emotional expression may shape eating disorder experiences, and to ensure that services are accessible, responsive, and respectful of all diverse cultures and identities.
Resources
For further information on how your PHN can support better responses to eating disorders with CALD and CARM communities, contact info@nedc.com.au
LGBTQIA+ people
Eating disorders disproportionately affect LGBTQIA+ communities, often driven by complex factors such as minority stress, discrimination, and social pressures around identity, body image, and acceptance. People in these communities may face higher rates of body dissatisfaction and stigma, yet lower access to affirming, safe and inclusive care. Gender diverse individuals, in particular, may experience eating disorders as a way of coping with dysphoria or societal expectations.
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In the Butterfly Foundation’s BodyKind youth survey, almost half of trans and gender diverse young people (48.5%) reported a high level of body dissatisfaction (Butterfly Foundation, 2024).
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Transgender men report a lifetime eating disorder prevalence of 10.5%, and transgender women 8.1%. For specific diagnoses, anorexia nervosa affects 4.2% of transgender men and 4.1% of transgender women, while bulimia nervosa affects 3.2% and 2.9%, respectively (Ngata et al., 2020).
Ensuring inclusive, affirming, and tailored support is essential to addressing both the psychological and systemic contributors to eating disorders in LGBTQIA+ populations.
Resources
For further information on how your PHN can support better responses to eating disorders with LGBTIQA+ communities, contact info@nedc.com.au
Refugees & asylum seekers
People from refugee and asylum seeker backgrounds face heightened vulnerability to eating disorders due to a complex interplay of trauma, displacement, cultural adjustment, and food insecurity. Their experiences may include prolonged stress, disrupted eating patterns, transgenerational trauma and limited access to consistent, culturally safe healthcare. Language barriers, stigma, and competing settlement priorities can further hinder recognition and timely support.
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Post-migration stressors can contribute to mental health challenges including eating disorders; however, this is currently a major gap in the research (Li & Nickerson, 2016).
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Refugees and asylum seekers often under-utilize mental health services due to barriers such as language difficulties, stigma, lack of awareness, and cultural differences in understanding mental illness (Satinsky et al., 2019).
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Adolescent Palestinian refugees showed a high prevalence of eating disorders and depression, with girls showing more cognitive concern and boys engaging in behaviours such as purging and excessive exercise (Damiri & Hanani, 2025).
Understanding the psychosocial context and tailoring care to be trauma-informed and culturally responsive is essential to reducing barriers and improving outcomes for these individuals.
Resources
For further information on how your PHN can support better responses to eating disorders with refugee and asylum seeker communities, contact info@nedc.com.au
Older adults
Eating disorders in older adults are often under-recognized and misunderstood, yet they can have serious physical and psychological consequences. Age-related changes in health, body image, social isolation, grief, and chronic illness can all contribute to the development or re-emergence of disordered eating. In some cases, restrictive eating may be linked to a desire to maintain control or cope with emotional distress.
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Menopausal transition in women and possible hormonal disturbances in men are critical periods where the risk of developing an eating disorder can increase (Mangweth-Matzek, 2017; 2023).
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Risk factors for disordered eating in older adults can include body dissatisfaction, loneliness, and low physical activity (Ye et al., 2024).
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Eating disorders in the older population can be exceptionally dangerous and have a high mortality rate (Lapid etal., 2010).
Because symptoms may present differently in later life, and are frequently overlooked as part of aging, it's essential that health professionals remain vigilant, offer respectful screening, and ensure access to age-appropriate support and treatment.
Resources
For further information on how your PHN can support better responses to eating disorders with older adults, contact info@nedc.com.au
Children & young people
Eating disorders often emerge during childhood and adolescence, a period marked by rapid physical, emotional, and cognitive development. Young people may be particularly vulnerable due to peer pressure, body image concerns, social media influence, family dynamics, lack of agency and underlying mental health challenges. Early signs can be subtle, and behaviours may be mistakenly dismissed as typical developmental changes.
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There has been a significant increase in children and young people experiencing eating difficulties since the COVID-19 pandemic
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Body dissatisfaction can occur in people as young as 6 (Koreshe et al., 2023).
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It is a myth that eating disorders only occur in
Timely recognition and intervention are crucial, not only to prevent long-term health consequences but also to reduce the risk of rapid deterioration and support young people in building life-long positive relationships with food, their bodies, and their emotions. An age-appropriate, family-inclusive, and evidence-informed approach to care is essential.
Resources
For further information on how your PHN can support eating disorders in this community, contact info@nedc.com.au
People living with a disability
People living with disability may face unique vulnerabilities to eating disorders due to intersecting factors such as physical differences, social isolation, communication barriers, socioeconomic disadvantage, dependence on others for care, and the medical complexity of their conditions. Symptoms of an eating disorder can be overlooked or misattributed to a person's disability, delaying diagnosis and care.
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Adults with intellectual and developmental disabilities, especially those with co-occurring autism , show higher rates of eating and feeding disorders (Bertelli et al., 2024).
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Whilst there is a lack of research in this space, emerging theories note the role of both individual factors (e.g., disability visibility, food access, self-identification) and sociocultural influences (e.g., ableism, weight stigma) in shaping the risk and lived experience of eating disorders within disabled people (Steinhoff et al., 2025).
Providing inclusive, accessible, and person-centered support is essential to ensure timely identification and meaningful recovery pathways for people with disabilities.
Resources
For further information on how your PHN can support better responses to eating disorders with the disability community, contact info@nedc.com.au
People living with a chronic illness
For someone living with a chronic illness, the relationship with food and body can be deeply affected by daily challenges Physical symptoms, medication side effects, complex relationships with nutrition, symptom management and fatigue can all interfere with appetite or body image.
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People with chronic health conditions, especially those requiring dietary management (e.g., diabetes, celiac disease, gastrointestinal disorders), are at increased risk for disordered eating behaviours and eating disorders compared to the general population (Avila et al., 2019; Conviser et al., 2018; Quick et al., 2013)
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Disordered eating in the context of chronic illness can lead to worsening disease symptoms, increased hospitalisations, and long-term health consequences (Avila et al., 2019; Conviser et al., 2018; Dzwiewa et al., 2023).
Recognising the interplay between chronic illness and eating behaviours is essential for delivering holistic, respectful, and integrated care.
Resources
For further information on how your PHN can support eating disorders in this community, contact info@nedc.com.au
References
Avila, J., Park, K., & Golden, N. (2019). Eating disorders in adolescents with chronic gastrointestinal and endocrine diseases. The Lancet. Child & Adolescent Health, 3(3), 181–189. https://doi.org/10.1016/S2352-4642(18)30386-9
Bańka, B., Dziewa, M., Herbet, M., & Piątkowska-Chmiel, I. (2023). Eating Disorders and Diabetes: Facing the Dual Challenge. Nutrients, 15. https://doi.org/10.3390/nu15183955
Bertelli, M., Paletti, F., Merli, P., Hassiotis, A., Bianco, A., & Lassi, S. (2024). Eating and feeding disorders in adults with intellectual developmental disorder with and without autism spectrum disorder. Journal of Intellectual Disability Research. https://doi.org/10.1111/jir.13195
Butterfly Foundation (2024). BodyKind Youth Survey: Your body image, Your voice 2024 report. Retrieved from http://www.butterfly.org.au/youthsurveyfindings
Burt, A., Mannan, H., Touyz, S., & Hay, P. (2020). Prevalence of DSM-5 diagnostic threshold eating disorders and features amongst Aboriginal and Torres Strait islander peoples (First Australians). BMC Psychiatry, 20. https://doi.org/10.1186/s12888-020-02852-1
Conviser, J., Fisher, S., & McColley, S. (2018). Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review. International Journal of Eating Disorders, 51, 187–213. https://doi.org/10.1002/eat.22831
Damiri, B., & Hanani, A. (2025). Prevalence and association between eating disorders, depression, and obesity among Palestinian adolescent refugees. BMC Psychology, 13, 734. https://doi.org/10.1186/s40359-025-03066-4
Gall, Z., Smith, H., Grant, G., Kunaratnam, K., Lee, C., Kerslake, F., & Gall, A. (2025). Culturally responsive recommendations for eating disorder prevention and management for First Nations peoples in Australia: A policy scoping review. Journal of Eating Disorders, 13. https://doi.org/10.1186/s40337-025-01243-9
Koreshe, E., Paxton, S., Miskovic-Wheatley, J., Bryant, E., Lê, Â., Maloney, D & Maguire, S. (2023). Prevention and early intervention in eating disorders: findings from a rapid review. Journal of Eating Disorders, 11. https://doi.org/10.1186/s40337-023-00758-3
Lapid, M., Prom, M., Burton, C., McAlpine, D., Sutor, B., & Rummans, T. (2010). Eating disorders in the elderly. International Psychogeriatrics, 22, 523–536. https://doi.org/10.1017/S1041610210000104
Li, S., Liddell, B., & Nickerson, A. (2016). The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers. Current Psychiatry Reports, 18, 1–9. https://doi.org/10.1007/s11920-016-0723-0
Mangweth-Matzek, B., & Hoek, H. (2017). Epidemiology and treatment of eating disorders in men and women of middle and older age. Current Opinion in Psychiatry, 30, 446–451. https://doi.org/10.1097/YCO.0000000000000356
Mangweth-Matzek, B., Kummer, K., & Hoek, H. (2023). Update on the epidemiology and treatment of eating disorders among older people. Current Opinion in Psychiatry, 36, 405–411. https://doi.org/10.1097/YCO.0000000000000893
Nagata, J., Ganson, K., & Austin, S. (2020). Emerging trends in eating disorders among sexual and gender minorities. Current Opinion in Psychiatry, 33, 562–567. https://doi.org/10.1097/YCO.0000000000000645
Nasser, M. (2009). Eating disorders across cultures. Psychiatry. https://doi.org/10.1016/J.MPPSY.2009.06.009
Quick, V., Byrd-Bredbenner, C., & Neumark-Sztainer, D. (2013). Chronic illness and disordered eating: a discussion of the literature. Advances in Nutrition, 4(3), 277–286. https://doi.org/10.3945/an.112.003608
Rodríguez-Arauz, G., Ramírez-Esparza, N., & Smith-Castro, V. (2016). Food attitudes and well-being: The role of culture. Appetite, 105, 180–189. https://doi.org/10.1016/j.appet.2016.05.019
Satinsky, E., Fuhr, D., Woodward, A., Sondorp, E., & Roberts, B. (2019). Mental health care utilisation and access among refugees and asylum seekers in Europe: A systematic review. Health Policy. https://doi.org/10.1016/j.healthpol.2019.02.007
Steinhoff, M., Longhurst, P., Gillikin, L., Cascio, M., Burnette, C., Gilbert, K., & Hahn, S. (2025). Disabilities and eating disorders: A theoretical model and call for research. Eating Behaviors, 56, 101951. https://doi.org/10.1016/j.eatbeh.2025.101951
Ye, H., Wang, Y., Xu, S., Tu, J., Hao, M., & Zhou, X. (2025). The effects of body dissatisfaction, lifestyle, and loneliness on emotional eating among older adults in Northeast China. Aging & Mental Health, 1–10. https://doi.org/10.1080/13607863.2025.2479188
To find out more about NEDC's current projects and our work alongside PHNs, please contact info@nedc.com.au