Eating Disorder Treatment Centers Are Not The Solution: ED Neoliberal Healthcare Will Not Save Us
A colored image of a room with white walls and a white closet door on the left. Room has two beds against the right wall. Beds are made and the floors are wooden. There are 3 windows in the back center of the room. There is a brown dresser on the left. The room is bright with natural light.
In recent years, the discourse surrounding eating disorders has largely been shaped by neoliberal perspectives that prioritize individualism, market-driven solutions, and a narrow understanding of health. However, a non-Western lens reveals the inherent flaws and limitations of this approach. By unpacking the impact of colonialism and capitalism on eating disorder healthcare, we can critically examine the ways in which neoliberalism perpetuates systemic inequities, fails to address the root causes of eating disorders, and reinforces harmful narratives. It is time to challenge the dominant neoliberal paradigm and advocate for an approach that pushes beyond the medical industrial complex.
What is Neoliberal Healthcare?
Neoliberal healthcare refers to a system of healthcare that is heavily influenced by neoliberal ideology and principles. Neoliberalism is an economic and political framework that prioritizes free markets, individualism, privatization, and limited government intervention. In the context of healthcare, neoliberalism advocates for the marketization and commodification of healthcare services, emphasizing individual choice, competition, and profit-making.
Under neoliberal healthcare, healthcare is often treated as a commodity rather than a fundamental human right. Private entities, such as insurance companies, pharmaceutical companies, and for-profit healthcare providers, play a significant role in the delivery and financing of healthcare services. The market-driven approach places a strong emphasis on cost-efficiency, competition, and consumer choice, with the belief that market forces will lead to improved quality and access to healthcare.
One of the key characteristics of neoliberal healthcare is the emphasis on individual responsibility and personal choice. Neoliberalism often promotes the idea that individuals are solely responsible for their own health and well-being, placing the burden on individuals to make informed choices and manage their own healthcare. This approach tends to overlook the impact of social determinants of health, such as poverty, inequality, and systemic factors, which significantly influence health outcomes.
Another aspect of neoliberal healthcare is the focus on cost containment and efficiency. Neoliberal policies often prioritize cost reduction, leading to austerity measures, budget cuts, and the outsourcing or privatization of healthcare services. This approach can result in limited access to care, reduced funding for public healthcare systems, and increased disparities in healthcare outcomes, particularly for marginalized and underserved populations.
Critics argue that neoliberal healthcare reinforces existing social and economic inequalities, as it tends to prioritize those with financial means and perpetuates a system that benefits the wealthy and leaves behind those who are most vulnerable. It also undermines the principles of equity, solidarity, and universality in healthcare by treating it as a commodity rather than a public good.
Rethinking Western Psychiatry and Psychology As Solutions for Today's Eating Disorder Epidemic
Is the growth of the eating disorder treatment industry & increased access to treatment the solution to today's epidemic of eating disorders?
It should be noted that this question does not imply that individuals seeking treatment should be discouraged from doing so. Rather, it questions the effectiveness of neoliberal psychiatry and Western psychology as a comprehensive answer to our problems, as they inherently align with and support a capitalistic system.
According to Susan Rosenthal, while the penal system manages individuals who break the law, psychiatry manages those who deviate from societal norms. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has played a role in promoting neoliberal capitalism, advocating for market deregulation, privatization of healthcare, and reductions in social services, particularly during the 1980s.
Western psychology and psychiatry tend to depoliticize and downplay systemic inequalities, shifting the focus onto the individual. Collective struggles are often reduced to individual cognitive and biological deficiencies.
Moreover, Western psychology and psychiatry possess the authority to define acceptable social behavior, often favoring behaviors that serve capitalist interests. In many instances, the criteria used to determine what is considered "normal" or "abnormal" behavior align with societal norms that prioritize productivity, conformity, and individual success within a capitalist framework. Behaviors that are seen as advantageous for capitalism, such as competitiveness, self-reliance, and productivity, are often promoted and reinforced as desirable traits. Those who deviate from or resist these norms are pathologized and, in some cases, subjected to medication, institutionalization, imprisonment, or social ostracism.
A critical examination of these systems is essential. By exploring alternative perspectives, embracing collective action, and engaging with critical theories, we can move towards a more equitable and inclusive approach to addressing eating disorders and mental health in general.
Unmasking the Limitations of Neoliberal Eating Disorder Healthcare Approaches
In the realm of eating disorder healthcare, it is crucial to critically examine the dominant neoliberal approaches and their limitations in addressing the complex needs of individuals.
The Individualization of Eating Disorders:
Neoliberal eating disorder healthcare places excessive emphasis on individual responsibility and personal choice, overlooking the complex social, cultural, and systemic factors that contribute to the development and perpetuation of eating disorders. By reducing eating disorders to individual pathology, this approach fails to acknowledge the impact of systemic oppression, trauma, and social determinants of health, further marginalizing and silencing marginalized communities.
Reductionist and Biomedical Focus:
Neoliberal eating disorder healthcare often adopts a reductionist approach that narrowly focuses on symptom management and physical health outcomes. This biomedical lens tends to overlook the multifaceted nature of eating disorders, neglecting the underlying psychological, social, and cultural factors that contribute to these conditions. By reducing eating disorders to solely individual pathology and medical interventions, neoliberal approaches fail to address the broader systemic factors that perpetuate and exacerbate disordered eating behaviors.
The Marketization of Recovery:
Neoliberalism has transformed eating disorder treatment into a profitable industry, with private clinics, self-help books, and commodified recovery narratives catering primarily to affluent individuals. This market-driven approach reinforces exclusivity and perpetuates inequities by prioritizing access for those with financial means, while neglecting the needs of marginalized populations who face additional barriers to healthcare, such as racism, poverty, and lack of cultural competence.
Ignoring Intersectionality:
Neoliberalism's individualistic framework fails to account for the intersectional experiences of individuals with eating disorders. Marginalized communities, such as Black, Indigenous, and People of Color (BIPOC), LGBTQ+ individuals, fat people and those with disabilities & chronic health issues, face unique challenges and discrimination that significantly impact their experiences of and access to care. Neoliberal approaches overlook the need for culturally sensitive and intersectional approaches that address the specific needs and systemic barriers faced by these communities.
Privatization and Profit-driven Models:
Neoliberalism promotes the privatization and commercialization of healthcare, transforming it into a profit-driven industry. In the context of eating disorder treatment, this has led to the proliferation of for-profit treatment centers and interventions that prioritize financial gain over the well-being of individuals. The commodification of eating disorder healthcare perpetuates inequalities, as access to quality care becomes contingent on financial resources, leaving many marginalized individuals without adequate support and perpetuating systemic inequities.
Limited Focus on Prevention and Social Determinants:
Neoliberalism tends to prioritize treatment over prevention and fails to address the root causes of eating disorders. It overlooks the impact of social determinants of health, such as poverty, food insecurity, body shaming, and media influence, which contribute to the development and perpetuation of disordered eating behaviors. By solely focusing on individual treatment, neoliberal approaches miss opportunities for comprehensive interventions that address the structural factors that fuel eating disorders.
Pathologization and Medicalization:
Neoliberal healthcare tends to pathologize and medicalize eating disorders, prioritizing diagnostic labels and symptom management over holistic and culturally sensitive approaches. This approach disregards the diverse experiences and cultural understandings of food, body, and well-being, perpetuating Eurocentric standards and marginalizing alternative healing practices. It fails to recognize the social and cultural determinants of health, impeding the development of interventions that address the underlying causes of eating disorders.
Lack of Community and Collective Healing:
Neoliberalism promotes competition and individual success, fostering an environment where communal support and collective healing are often overlooked. Eating disorder recovery thrives in spaces that prioritize community connection, cultural healing practices, and intergenerational support. Neoliberal healthcare, focused on individual outcomes and quick fixes, neglects the importance of community and undermines the potential for transformative change.
So, what’s next?
It is essential to challenge and confront the dominant neoliberal paradigm in eating disorder healthcare, while actively striving for an alternative form of care that is rooted in anti-capitalist and anti-colonial principles. Here are several steps we can take to untangle ourselves from the internalized and externalized aspects of neoliberal and capitalist approaches to eating disorder care:
Identify and critically examine our reliance on eating disorder healthcare that has never prioritized the health of Black people
Stop romanticizing eating disorder recovery stories that never acknowledge that eating disorder healthcare is broken and leaves the majority of people with eating disorders without care.
Do not stay silent when BIPOC speak out against the injustices in the eating disorder industry. Do no ONLY speak out against eating disorder enterprises and non-profits when it predominantly affects white individuals.
Expand our imagination beyond the confines of Western healthcare paradigms and explore alternative approaches to healing.
Normalize conversations and actions that revolutionize eating disorder care by transcending traditional structures and embracing community autonomy and free care.
Study and learn from healing modalities that existed prior to the dominance of the medical industrial complex.
Seek inspiration from autonomous health movements around the world, acknowledging the wisdom and knowledge they offer in challenging oppressive systems.
Legitimize demedicalized care and community-dependent approaches, recognizing the importance of collective support and empowerment.
Disrupt and question eating disorder healthcare authority, challenging the power dynamics that often perpetuate harm and marginalization.
A reimagined approach to eating disorder healthcare acknowledges the interconnectedness of these conditions with broader social, cultural, and historical contexts. It emphasizes the need to address systemic inequities and structural factors, moving away from profit-driven individual blame towards healing, justice, and collective well-being. An anti-colonial and anti-neoliberal eating disorder healthcare, demands that we commit to dismantling oppressive systems, promoting social justice, and empowering communities in their journey towards self-determination.
