Taking a Social Justice Perspective on Eating Disorders

What does it mean to take a social justice perspective on eating disorders? Is it just an elitist catch phrase used to make us focus on only socio-cultural contributors to eating disorders, without taking into account the biological and genetic components of these conditions? What is social justice, anyway, and what in the world do eating disorders have to do with it?

Social justice means thinking at a systems level – meaning political, economic, social and other systems like government, corporations, institutions, and more – to consider how we might better support equitable access to needed services and supports of all kinds for diverse people. It means understanding that people have different social locations – that is, different positions and ways of being in the world. Social locations are linked to the idea of social power, or who in society tends to be more privileged and who tends to be more marginalized. Looking at social justice from an intersectional perspective means considering that differences in social location are not just a matter of belonging to unified groups like “women”; it is important to consider, for example, how the experiences of a white woman who identifies as heterosexual would differ from those of a black woman who identifies as heterosexual, which would again differ from those of a white woman who identifies as queer (and so on and so forth). 

In the context of eating disorders, a social justice lens can help us to understand how people with eating disorders might, for example: 

  • Be able (or not able) to access treatment
  • See themselves recognized as “legitimately suffering” in the eyes of authority figures like doctors 
  • Experience disconnects or unity in their own sense of distress around food, weight and shape and those of their families
  • Experience treatment as helpful or unhelpful
  • Have a good sense of what recovery might look like for them

Of course, taking a social justice lens helps us to understand other aspects of the experiences of people with eating disorders and their families. However, these examples help us to see how this lens can help us to move beyond simplistic perspectives on eating disorders that present them as issues of personal choice or vanity. Using a social justice lens means pointing out that people with eating disorders face many stereotypes and stigmas in general, which might be made worse if they do not fit the “expected picture” of what someone with an eating disorder looks or acts like. It also helps us to identify what we need to do to make treatment more accessible and appropriate for diverse people.

Perhaps the clearest example of how using a social justice lens can help us to see the complexities of people’s lives is access to treatment. Often, I meet parents who love the idea of family based treatment for eating disorders – family based treatment puts treatment in the hands of parents who support their child to recovery and has been shown to be quite effective for younger patients who have a short course of disorder and who have never been hospitalized. However, many parents are unable to quit their jobs or move to an urban centre to find a practitioner skilled in this approach. Socioeconomic constraints like needing to keep working and location constraints like living in a rural area without access to many (if any) eating disorder specialists prevent these families from being able to reach the support they need and desire. 

Cultural norms can also be serious impediments to treatment access. We often take for granted that people will be able to identify a mental health issue and speak openly about it, at least to family and friends. However, airing health issues in general and mental health issues in particular outside of the home is frowned upon in cultures with a focus on presenting a strong and proud family front in society – often families who have faced racialization in society. The threat of “losing face” in a society that asks us to be our best at all times is significant, particularly when you have faced systemic racism or other discrimination.

These are only two examples of how looking at eating disorders from a social justice perspective can help us to identify factors beyond the individual person that impact people with eating disorders and their families. If our analyses are social justice based, of course, so too must our solutions be social justice based – we need to take this understanding and work not only on helping individual people but on building more comprehensive supports for those who struggle.

What does systems level change in the service of social justice look like, in practice? It can take many shapes, but a few examples include:

  • Join in on events like March Against ED, an annual rally taking place at provincial legislative assemblies (check out the National Initiative for Eating Disorders (NIED) recap of this past year’s event here, including a video I created about the event:
  • Use social media outlets like Twitter to break down stereotypes about eating disorders either in Tweet form or by providing links to resources like blogs or statistics
  • Micro-advocacy can involve speaking up if someone says something about eating disorders that you know to be untrue or stigmatizing

Of course, never feel that you have to be the one to correct all of society’s ills – all of these strategies (and others!) are best achieved together. 

- Andrea Lamarre