1. UNDERSTANDING EATING DISORDERS There are many components to a thorough understanding of eating disorders in our society and all knowledge that contributes to an understanding of this complex issue is valuable. At EDQ we have a bio-psycho-social understanding of eating disorders where we see eating disorders as a complex interaction of mental health, developmental and familial experiences, trauma related experiences, genetic predispositions, social and cultural forces, and the interrelationship between these various factors. Eating disorders are complex issues that have significant impacts on a person’s emotional and physical health as well as impacting on those who care for and support the person. 1. Eating disorders are maladaptive coping strategies that have been created and maintained by our society. Our society plays a role in the incidence of eating disorders. We need to see eating disorders within the larger context of our social preoccupation with dieting and weight loss and socially approved body images and sizes6. Eating disorders should be approached from a perspective that is informed by the broader social and cultural forces that encourage the objectification of bodies and that values specific body shapes and sizes rather than unique and diverse bodies. 2. Feminist approaches to understanding and working with people with eating disorders have provided an alternative understanding that is complementary to other approaches. In the 1990s feminist therapists suggested that eating disorders were an expression of a greater problem for young women and these underlying issues give
rise to difficulties with eating. It was suggested that eating disorders were obsessions with food and these obsessions were designed to conceal a greater conflict in the person’s life7. Therefore, the eating behaviours could be seen as the solution the person had found to a greater problem in their life. There is now an undeniable evidence base within neurobiology for the practice principles that feminism has developed over many years of work with women with serious eating disorders8. More recently, the feminist-relational model, which promotes the importance of relationships and connection, has been applied to the field of eating disorders9. Importantly, this perspective combines two overlapping spheres involving the relationship and political contexts within the social world10. This approach includes attention to connection, social support, voice, empowerment and feminist identity. A rich body of literature informs feminist approaches to understanding and working with eating disorders. 3. Eating disorders are adaptive coping strategies. Eating disorder behaviours are designed to keep the person safe11. It is important to acknowledge that this is a protective part, despite the significant health implications of this issue. Eating disorders are the solution that person has found to assist them in coping with other life problems and will not shift until the person address the underlying issues giving rise to their behaviours12. 4. Issues of power and control are central to all forms of eating disorders. A strong correlation exists between eating disorders and experiences of loss of power and control that a person has had in their life. For many people with an eating disorder, their eating behaviour allows them to feel in control of some aspect of their life. No
Fahs, B. & Swank, Er. (2017) ‘Exploring stigma of “extreme’ weight gain: The terror of fat possible selves in women’s responses to hypothetically gaining one hundred pounds’, Women’s Studies International Forum, 61, 1-8; Fikkan, J. L., & Rothblum, E. D. (2011) ‘Is fat a feminist issue? Exploring the gendered nature of weight bias’, Sex Roles, 66, 575-592; Matacin, M.L. & Simone, M. (2019) ‘Advocating for Fat Activism in a Therapeutic Context’, Women and Therapy, 442:1-2, 200-215; Smith, C.A. (2012) ‘The Confounding of Fat, Control, and Physical Attractiveness for Women’, Feminist Forum, 66, 628-631. 7 Lawrence, M. (1984) The Anorexic Experience, The Women’s Press: London. 8 Chami, R. & Treasure, J. (2019) ‘The Neurobiology of Trauma and Eating Disorders’, in Seubert & Virdi eds., Trauma-Informed Approaches to Eating Disorders, Springer Publishing: New York, 59-74. 9 Maine, M., & Bunnell, D. (2008) ‘How do the principles of the feminist, relational model apply to treatment of men with eating disorders and related issues?’, Eating Disorders, 16, 187–192; Wacker, E.C. (2018) ‘Application of the Feminist-Relational Model for the Treatment of Subclinical Eating Disorders’, Journal of Feminist Family Therapy, 30:2, 71-89; Wacker, E.C., Dolbin MacNab M.L. (2020) ‘Feminist-Informed Protective Factors for Subthreshold Eating Disorders’. Qualitative Health Research, 30:10, 1546-1560. 10 Wacker, E.C. (2018) ‘Application of the Feminist-Relational Model for the Treatment of Subclinical Eating Disorders’, Journal of Feminist Family Therapy, 30:2, p. 75. 11 Finlay, H.A. (2019) ‘Recognising the Territory: The interaction of trauma, attachment injury, and dissociation in treating eating disorders’, in Seubert & Virdi eds., Trauma-Informed Approaches to Eating Disorders, Springer Publishing: New York, 35-44. 12 Lawrence, M. (1984) The Anorexic Experience, The Women’s Press: London. 13 Peterson, R.D., et al. (2008) ‘Empowerment and Powerlessness: A closer look at the relationship between feminism, body image and eating disturbance’, Sex Roles, 58, 639-648; Wacker, E.C. (2018) ‘Application of the Feminist-Relational Model for the Treatment of Subclinical Eating Disorders’, Journal of Feminist Family Therapy, 30:2, 71-89. 6
Eating Disorders Queensland
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