Title : Beyond food and diagnosis: Culture, family, and healing in pediatric eating disorders
Abstract:
Over the past six decades, immigration patterns in the United States have shifted significantly, resulting in increased cultural, linguistic, and religious diversity among patient populations. At the Children's Health Center for Pediatric Eating Disorders, clinicians treat children and adolescents ages 5–18 years with eating disorders including Anorexia Nervosa, Bulimia Nervosa, and Avoidant/Restrictive Food Intake Disorder (ARFID). Providers increasingly work with immigrant and multicultural families whose cultural values, acculturation levels, migration experiences, and beliefs about mental health influence treatment engagement and outcomes. Within this context, cultural humility is essential to strengthening therapeutic alliance and delivering responsive, family-centered care. As frontline caregivers who are often the first and most consistent point of contact for patients and families, nurses are uniquely positioned to model and sustain culturally inclusive, trauma-informed, and relationship-centered care throughout the treatment journey. Although family-based treatment (FBT) remains a gold standard approach for pediatric eating disorders, limited attention has been given to the influence of cultural identity, immigration experiences, social determinants of health, systemic inequities, and culturally shaped beliefs about mental health on treatment participation and family dynamics. Standard treatment approaches may unintentionally overlook cultural meanings related to food, body image, caregiving roles, emotional expression, and help-seeking behaviors, as well as the impact of financial hardship and food insecurity on recovery and treatment adherence. Consequently, culturally diverse families may experience misunderstanding, mistrust, stigma, or barriers to sustained engagement in care and nurses who lack the tools to recognize and respond to these dynamics may inadvertently reinforce them. This presentation will explore the application of cultural humility in pediatric eating disorder treatment through a framework that integrates cultural knowledge with ongoing self-reflection, curiosity, and awareness of clinician bias. Participants will examine how acculturation, intergenerational differences, discrimination, systemic barriers, financial hardship, food insecurity, and other social determinants of health influence clinical presentation, treatment engagement, and outcomes. The presentation will highlight resilience factors commonly observed within immigrant and multicultural families and discuss how nurses can actively leverage these strengths to support recovery and deepen therapeutic alliance. Practical strategies for building trust, addressing implicit bias, and navigating cultural and systemic barriers to care will be discussed with nursing practice specifically in mind. Through case-based discussion and clinical examples, participants will leave with concrete tools for engaging culturally diverse families in ways that are both clinically effective and culturally responsive.
