By Sheena Roetman for Sovereign Bodies, cross-posted with permission

When most people think about eating disorders, they most likely conjure up a very specific image—a thin, white, upper-class woman. After all, eating disorders have been considered “a rich girl’s disease” for quite some time. A quick Google search for eating disorder treatments reflects this—treatment centers are often massive, spa-like desert facilities with “dude ranch” themes costing upwards of $50,000 per stint. They focus almost exclusively on food—weight gain, “mindful eating,” food relationships, etc.

So what happens when a poor, non-white woman has an eating disorder? What are her options? Where does she go? Again, a quick Google search tells a lot.

The closest result to any sort of culturally sensitive treatment is a ranch that incorporates “Native American healing practices” into its treatment curriculum—sweat lodges, “Native American ceremonies,” and medicine wheels, to be specific. But the vague inclusion of these cultural identifiers isn’t there for Native women suffering from a disordered relationship with food. It’s there to attract rich white women into believing they are being healed by some deeper power.

So while our ceremonies are being bastardized by treatment centers around the country, Native women are left with very few resources to deal with what is quickly becoming an epidemic. As assimilation policies creep closer and closer to the finish line, Native American youth are becoming the second-highest risk group for eating disorders after white adolescents, with 48.1 percent reportedly trying to lose weight.

A large part of the problem stems from the fact that there are virtually zero spaces for Native women to talk about eating disorders. Many women grow up and live away from their home communities in urban centers with few cultural ties outside the Internet. Additionally, while feelings of guilt and shame are common in all cases of disordered eating, these feelings intensify in communities where poverty, and therefore starvation, is an everyday reality.

Even if we want to talk about it, we’re too ashamed to do so, because “there are more important things.”

We need to acknowledge and confront the lack of resources for people suffering from eating disorders in our communities. We have vastly improved upon programs for suicide prevention, alcohol and drug addiction, diabetes, and domestic and sexual abuse, but we have yet to address this growing problem in Indian country.

All of these problems are symptoms of colonialism, and all of them require healing that is based in cultural and spiritual beliefs and involves the community and the land. This is sovereignty at its most fundamental level — using our traditional knowledge and ceremony to lift each other up and heal our communities from within.

Sheena Roetman writes prolifically on race and gender in sociological discourse and imagery, particularly on how it affects Indigenous populations in America. She has contributed to Indian Country Today, Last Real Indians, Thought Catalog, CommonCreativ, and Urban Native Mag, among other journals.