Eating Disorders as a Public Health Challenge: A Case Study of Inclusive, Systems-Oriented Treatment in the US Southeast.

Abstract

Abstract: Eating disorders in the United States have increased substantially over the past 2 decades, with additional exacerbation during the COVID-19 pandemic. These conditions disproportionately affect adolescents, young adults, and sexual and gender minority (SGM) populations, reflecting the influence of stigma, discrimination, and broader social determinants of health. Given their complexity, high comorbidity, and elevated mortality risk, eating disorders represent a significant public health concern requiring a continuum of care that spans outpatient, partial hospitalization, residential, and inpatient treatment settings. Emerging evidence underscores the importance of trauma-informed, culturally responsive, and affirming approaches in improving engagement and outcomes for SGM individuals, who often encounter barriers to inclusive and competent care. This case study examines NewCircle at Hanover, a recently established eating disorder treatment center in Birmingham, Alabama, that operationalizes an intersectional, SGM-affirming model of care across multiple levels of service. The program integrates evidence-based clinical interventions with intentionally designed organizational structures, physical environments, and expressive therapies to support whole-person recovery. Attention is given to how governance, facility design, and clinical programming intersect to shape treatment engagement, continuity of care, and client experience.