You Deserve Excellent Care: Self-Advocacy Scripts for Marginalized People in Eating Disorder Recovery
For too long, eating disorders have been framed as a “thin, white, cisgender, wealthy, teenage girl problem.” That stereotype is not only inaccurate, it is dangerous.
BIPOC, fat, disabled, and LGBTQIA+ people develop eating disorders at similar or higher rates than their thin, white, cisgender peers, yet are far less likely to be screened, believed, or offered appropriate care. Many of us learn quickly that seeking help can feel risky. We may be dismissed, misdiagnosed, shamed, or harmed by providers who lack training in eating disorders or cultural humility.
And yet even though that is true, we deserve adequate (if not excellent) medical care. We deserve care that is centered around safety, informed consent, collaboration, and respect for our full humanity.
Self-advocacy can be exhausting, especially when you’re already struggling. Having a script to set the stage can help during the vulnerable first steps of establishing care or communicating your needs with a (new) provider. Scripts can offer language when your nervous system is overwhelmed, when shame is loud, or when you fear you might lose your words or be misunderstood. They are meant to help empower you to assert your right to adequate care.
You can adapt the following scripts for email, MyChart messages, phone calls, or in-person conversations with medical and mental health providers.
You don’t have to use every word. Take what fits. Change what doesn’t. Your voice and individual needs and concerns are what matters most. The hope is that these will be an outline to help empower you to get your needs met.
You may also choose to add language about your identity, access needs, or past medical trauma. This might include your gender identity, disability, neurodivergence, cultural background, or the ways healthcare has harmed you before. These details are relevant to your safety and the quality of care you receive.
Please note: I am a fat, chronically ill, gender-fluid, neurodivergent person who wrote these scripts through the lens of those intersecting identities, while also holding privilege as a white, cis-passing person who also holds some level of privilege within the fat community.
Script 1: Requesting an Initial Eating Disorder Screening
Purpose: For reaching out to a primary care physician (PCP), therapist, dietitian, or treatment center when you suspect you may have an eating disorder.
Hello, my name is ________. I’m reaching out because I’m concerned about my relationship with food and my body, and I would like to be screened for an eating disorder. [Optional: insert specific behaviors you are struggling with here.]
I want to be clear that this concern is affecting my physical and mental health, and I’m seeking care that is focused on safety, collaboration, and informed consent.
Because I **[am part of a marginalized community], I’ve had experiences where my concerns were minimized or misunderstood. It’s important to me that any screening or conversation be approached without assumptions based on my body size, identity, or background.
I’m looking for a provider who can listen carefully, take my concerns seriously, and help me understand next steps if support is needed. If this is something you believe you can help me with, I look forward to speaking with you.
If you feel this is outside your scope or values within your practice, I would appreciate any referrals you can provide to someone who meets my needs.
Thank you for your time.
**More specified language that is optional to insert: live in a larger body, am a disabled person, am a BIPOC individual, am a gender diverse/fluid person, am a trans person, etc.
Why this advocacy script can help: This script clearly names concerns without needing to try to “prove” your illness. It sets expectations for being the recipient of respectful care. Without explaining all of the reasons why, it still states the need for weight-inclusive, identity-affirming treatment. And it centers you as a human and states the safety you deserve within healthcare facilities.
Script 2: Requesting an Appointment with a New Provider for Eating Disorder-Specific Care
Purpose: For those who know they have an eating disorder and need ED-specific care, whether a new therapist, doctor, registered dietitian, or other outpatient provider.
Hello, my name is ________. I’m reaching out to inquire about becoming a new patient. I am seeking support for an eating disorder and want to make sure I find care that feels safe and collaborative.
I **[am part of a marginalized community], and past healthcare experiences have sometimes been harmful rather than helpful. Because of that, I’m hoping to work with a provider who:
Has experience treating eating disorders
Practices with informed consent at the forefront
Does not make assumptions based on **[keep what is relevant to you: weight, race, disability, gender, or sexual orientation]
Is open to working collaboratively with me rather than taking a one-size-fits-all approach
If possible, I would love to know more about your approach to eating disorder care and whether you feel you would be a good fit for someone with my background and needs. If you feel this is outside your scope or values within your practice, I would appreciate any referrals you can provide to someone who meets my needs.
Thank you for your time and care in responding. I appreciate your willingness to help me take this step toward recovery.
**More specified language that is optional to insert: live in a larger body, am a disabled person, am a Person of Color, am a gender diverse/fluid person, am a trans person, etc.
Optional Additions
You may also choose to add one or more of the following lines depending on your identity and needs:
Optional add-ons for larger-bodied patients:
Provides weight-inclusive rather than weight-focused care
Avoids attributing health concerns to the size of my body
Avoids using stigmatizing or moralizing language about my body
Recommends medical decisions based on symptoms and labs, rather than body size
Optional add-ons for trans, intersex, and gender diverse patients:
Respects my gender identity and uses my correct name and pronouns
Ensures that my eating disorder is not framed as a result of my gender identity or transition
Is informed and respectful of intersex bodies and medical trauma
Optional add-ons for BIPOC patients:
Understands that food and body norms differ across cultures
Acknowledges how racism and cultural context affect my health
Optional add-ons for disabled and chronically ill patients:
Understands that I have a disability/chronic illness that affects how my body responds to treatment
Is able to meet my needed accommodations to fully participate in care (for example: longer appointments, written instructions, mobility access, or sensory considerations)
Avoids attributing all of my symptoms solely to my eating disorder or my disability
Optional add-ons for neurodivergent patients:
Understands that rigid food rules or abstract guidance are not helpful for me. I need concrete, collaborative support.
Avoid using shame, fear, or punishment as motivation
Understands that I need care that does not rely solely on Intuitive Eating
Provides care that understands neurodivergence and sensory needs
Why this advocacy script can help: This script filters for safer providers before you commit to sessions/treatment. It frames care as relational rather than an authority dynamic. It emphasizes fit and collaboration. Finally, it works to protect you against potential medical retraumatization.
Script 3: Disclosing an Eating Disorder to a Non-ED Provider (i.e., Dentist, Surgeon, Primary Care Physician, Specialist, etc.)
Purpose: For situations where you need to share relevant information so care is not harmful.
Before we begin working together, I want to share something important about my health. I have a history of an eating disorder, and certain comments, measurements, or recommendations can be triggering or unsafe for me.
What would be most helpful is if we could:
Avoid discussing weight or numbers unless medically necessary
Focus on the reason for today’s visit
Check in with me before offering advice related to food, exercise, or body size**
I want to receive care that supports my overall wellbeing and recovery. If this is something you believe you can help me with, I look forward to meeting you/working with you. If we move forward together, please document these preferences in my chart so I don’t need to re-explain them each visit.
If you feel this is outside your scope or values within your practice, I would appreciate any referrals you can provide to someone who meets my needs.
Thank you for your time.
**An alternative to “check in with me before offering advice related to food, exercise or body size”:
Refer any advice related to food, exercise, or body size to my [insert eating disorder team member you trust to know how to handle these topics well here: therapist, dietitian, primary care physician]
A Similar but Abbreviated Script
I want to let you know I’m in recovery from an eating disorder. For my safety, I need our care today to avoid weight-centric language and to stay centered on the concern at hand.
Why these advocacy scripts can help: Stating these needs and expectations beforehand can help prevent harm before it happens. It sets boundaries clearly instead of risking feeling like you’re fumbling for the “correct” words in the heat of the moment. This script stays solution-focused, keeping the priority of your time together centered on your safety and your individual needs.
A Reminder for Members of Marginalized Communities
If you are BIPOC, fat, disabled, neurodivergent, chronically ill, or a member of the LGBTQIA+ community, it is likely that you have been taught both explicitly and implicitly that you are too complicated for care; that your body disqualifies you from diagnosis or adequate treatment; that your body or identity is the problem; and that you should just be grateful for whatever care you get.
NONE of that is true.
We know that eating disorders do not discriminate. But unfortunately, our current healthcare system does.
Self-advocacy is exhausting, as is refusing to shrink yourself to fit a system that was never built with you in mind. You deserve to be believed, to be listened to, and to be treated with dignity and respect. You deserve adequate (if not excellent) care. If a provider cannot offer that, it is not a failure on your part.
You Are Not Asking for Too Much
These scripts are invitations to healthcare providers to practice in ways that are ethical, trauma-informed, and humane. As you seek adequate care, please remember that recovery is about so much more than just food. It is about reclaiming agency. It is about safety. It is about being seen fully. You deserve all of that and more.
If you are reading this and wondering if you deserve this kind of help, let this be your answer: You do. You don’t have to be thin. You don’t have to be white. You don’t have to be cis or straight. You don’t have to be able-bodied. You don’t have to be ‘sick enough’ to deserve care. You just have to be human. And humans deserve adequate (if not excellent) healthcare.
