Understanding stigma in the context of help-seeking for eating disorders

Stigma is a complex construct and its association with help-seeking among those experiencing eating disorders is not well understood. Rates of help-seeking are low for those with eating disorder symptoms and, therefore, determining the role of stigma and shame in this relationship is needed to help inform effective awareness campaigns aimed at improving prognostic outcomes. The current study examined the associations between perceived stigma, self-stigma, shame, and help-seeking behaviour in a community sample of individuals with elevated eating disorder symptoms. Participants completed an online survey that included measures of stigma and shame as perceived barriers to help-seeking for individuals with eating disorders. Those with elevated eating disorder symptoms and high clinical impairment were included in the study (N = 333). Using binary logistic regression models controlling for age and gender, results showed that perceived stigma, self-stigma, and shame predicted 64% of help-seeking behaviour (p = .005). The only significant unique predictor of formal help-seeking was “Being concerned that other people believe eating disorders are not real illnesses”. No other stigma or shame items were found to significantly predict help-seeking. The present findings suggest that while stigma plays an important role in help-seeking, it might not be the primary reason preventing individuals with eating disorders from accessing care. The field is encouraged to investigate these factors to promote help-seeking effectively. Eating disorders are highly prevalent worldwide and have severe mental health and medical consequences. While effective treatments for eating disorders exist, many of those who experience eating disorder symptoms do not reach out for help. Delays in help-seeking are associated with negative outcomes for affected individuals but also their families, caregivers, and the broader healthcare system. To better understand the factors preventing individuals with eating disorders from seeking help, we investigated the role of stigma and shame in this relationship. Participants completed a survey assessing their eating disorder symptoms, help-seeking behaviour, and barriers to seeking help. Those with elevated eating disorder symptoms (e.g., disordered eating and/or high weight and shape concerns negatively affecting their life) were included in the study. Participants reported that stigma and shame, specifically, “Being concerned that other people believe eating disorders are not real illnesses”, prevented them from seeking help. Our results help to clarify the types of stigma most relevant to help-seeking, which may be targeted in awareness campaigns to improve access to care for people with eating disorders. It would be beneficial for future studies to explore other prominent help-seeking barriers to improve clinical outcomes.