We Are Tired of The Negligence and Incompetence: An Open Letter to the Eating Disorder Recovery Industry

Disclaimer: Various individuals with diverse political beliefs and perspectives have contributed to the crafting of this letter. It encompasses a spectrum of approaches and demands, spanning from abolitionism to non-authoritative and reformist viewpoints. 

Dear Eating Disorder Recovery Industry,

We, the members of the Eating Disorder Harm Reduction Workers and friends, are writing this open letter to bring forth our demands and express our concerns regarding the current state of the eating disorder recovery industry. As individuals committed to harm reduction and advocating for marginalized communities, we feel it is essential to address the following issues and demand necessary changes to decentralize the dominant influences and systems and create a more ethical and effective approach to eating disorder care, treatment and recovery.

Indigenous and Black Liberation at the Center and Front

Treating eating disorders does not start and end with just “food.” The global community's progress hinges upon the liberation and empowerment of Black individuals. Eating disorders have deep-rooted connections to the systemic issue of anti-Blackness. As long as we neglect to acknowledge the deep-seated connection between anti-Blackness and its far-reaching impact on health disparities, we will be unable to effectively prevent and eliminate eating disorders.

It is imperative that we prioritize the safety, well-being, and flourishing of Black individuals within the eating disorder field. By safeguarding and nourishing Black providers, we can help break the cycle that perpetuates these disorders. To truly address and eventually eliminate eating disorders, we must recognize the profound links between anti-Blackness and the disparities in health that persist. Our efforts to combat these disorders must be underpinned by a commitment to dismantling systemic racism.

We emphasize the importance of actively taking part in Indigenous sovereignty land back efforts as well as Black liberation. Recognizing the historical and ongoing impacts of colonization, land theft, and the high rate of Missing and Murdered Indigenous Women and Two-Spirits is essential in the pursuit of justice and healing. Eating disorder treatment centers should actively support indigenous communities' self-determination and their efforts to reclaim and protect their ancestral lands. This includes advocating for the return of Indigenous lands, supporting Indigenous-led initiatives, and respecting the rights and sovereignty of Indigenous peoples.

Understanding the intersecting oppressions faced by Black and indigenous individuals is essential in creating a more equitable and inclusive approach to eating disorder treatment. Aligning with Black liberation is an ongoing process that requires continuous self-reflection, education, and betrayal to white comfort. The eating disorder industry must actively collaborate with Black liberation organizations and communities to create meaningful change. 

Actively Decenter Whiteness & Thinness in the Eating Disorder Narrative

We demand that the eating disorder recovery industry actively decenter whiteness and thinness in the narrative surrounding eating disorders. It is unacceptable for the industry to perpetuate a singular image of what an eating disorder looks like, which marginalizes individuals in larger bodies, people with disabilities, and those from diverse racial and ethnic backgrounds. We ask the professionals who fit the eating disorder stereotype to stop speaking on our (people who have been marginalized) behalf. By embracing a more unbiased narrative, we can create spaces for everyone seeking support and foster a deeper understanding of how eating disorders manifest in various communities. Furthermore, eating disorder treatment centers should actively examine their own practices and policies to ensure that they are not perpetuating or replicating systemic injustices. This includes addressing issues such as accessibility, affordability, and representation within the treatment center itself. Centers must strive to provide culturally sensitive and responsive care that acknowledges the unique experiences and needs of diverse communities.

Fat, Femme, BIPOC GNC and Transgender Women to the Front

It is crucial to amplify the voices of transgender people within the eating disorder community. However, there is an overrepresentation of predominantly cisgender gay men and white/light skinned who are: non-fat, masculine-presenting transgender individuals, asexual individuals, and gender non-conforming individuals dominating the discourse and taking up most of the space.

As part of decentering whiteness and thinness we need to see Transgender, Gender Diverse and Two Spirit providers as part of education, treatment and in treatment conversations. We no longer accept thin, white, Trans-Masc providers as the "most marginalized" a treatment center has to provide. This continues to adhere to toxic masculinity, the patriarchy and the very stereotypes that harm both providers and clients.

We have no issues with providers inhabiting thin, white, Trans-Masc bodies. What we do have issue with is that these are the voices of the Trans community that are the ones most visible in the field, that get the most credit, and their voices are centered as speaking for the whole Transgender, Gender Diverse and Two Spirit community when these voices do not accurately reflect the diversity within these communities.

In order to create a more all-around dialogue, we must actively seek out and uplift the experiences of transgender individuals from all backgrounds, body sizes, gender presentations, and sexual orientations. It is essential to recognize and address the intersecting identities and unique challenges faced by individuals who may not fit the prevailing narrative.

Neoliberal Eating Disorder Healthcare Will Not Save Us
It is essential to critically examine the limitations and shortcomings of the neoliberal model of eating disorder healthcare. The creation of more money-cranking treatment centers is not the solution. While the current system may prioritize profit-driven approaches, it often fails to address the root causes of eating disorders and provide comprehensive, accessible, and patient-centered care.

Neoliberalism's focus on individual responsibility and market-driven solutions overlooks the systemic factors that contribute to eating disorders, historical oppression, such as societal pressures, cultural norms, and socioeconomic inequalities. By solely emphasizing individual choice and personal responsibility, the neoliberal approach disregards the larger social, cultural, and economic contexts that shape our relationships with food and body image.

To truly address eating disorders, we need to challenge the neoliberal paradigm and advocate for a more wholesome and liberatory approach. 

We Don’t Need More Treatment Centers, We Need Mutual Aid Centers and Communities

We urge the deconstruction of the current eating disorder treatment model and the creation of mutual aid-based centers. The existing treatment model often perpetuates power imbalances, limited accessibility, and a narrow understanding of recovery. It is time to reimagine and transform the way we approach eating disorder care.

To truly address the complex nature of eating disorders and provide integrative support, we must prioritize mutual aid principles and actions. Mutual aid emphasizes collaboration, community support, and shared resources, centering the expertise and lived experiences of those affected by eating disorders. It promotes a sense of solidarity, fostering an environment where individuals can find validation, understanding, and empowerment.

The current treatment model often relies on hierarchical structures, where professionals hold most of the decision-making power. This approach can limit the agency and autonomy of individuals seeking support. Instead, we call for non-hierarchical decision-making processes in treatment centers, where all stakeholders, including individuals accessing care, loved ones, and staff members, have a voice and influence in shaping policies, programs, and services.

We advocate for an intersectional approach that recognizes and addresses the intersecting factors that contribute to eating disorders. Marginalized communities face unique challenges and barriers to care due to systemic inequalities. Mutual aid-based centers must actively work to dismantle these oppressive structures and collaborate with community organizations and activists who have expertise in working with marginalized populations.

Make Room for Other Worldviews and Non-Western Health Modalities

Western civility and present-day colonialism perpetuate malignancies. The influence of Western civility and modern colonialism has shaped societies and systems in ways that have perpetuated inequality, genocide, and climate disaster. The eating disorder (ED) industry must recognize the need to move away from solely adhering to Western thought and embrace a broader range of worldviews and non-Western health modalities. Acknowledging that eating disorders affect individuals from diverse cultural backgrounds, it is essential to consider alternative perspectives on health and healing. Incorporating non-Western health modalities, such as traditional healing practices, holistic approaches, and indigenous knowledge systems, can offer valuable insights and strategies for supporting individuals with eating disorders. These practices should always be hosted by people who come from the originators of such practices to avoid cultural appropriation. By making room for these diverse perspectives, the ED industry can create a more comprehensive and personalized approach to treatment that respects and honors the cultural diversity of those seeking help, leading to improved outcomes and more effective care.

End Cultural Appropriation

It is crucial to acknowledge and respect the origins of indigenous practices such as yoga, intuitive eating, and mindful eating, which have existed long before the establishment of Western eating disorder treatment. Cultural appropriation, an insidious feature of colonialism, involves the problematic "re-discovery" of these practices by white individuals, followed by claims of invention and a subsequent dilution for commercial purposes. However, in reality, the knowledge and wisdom behind these practices belong to indigenous communities who have nurtured them for generations. To foster authenticity and honor the cultural heritage of these practices, it is essential to end cultural appropriation and ensure that they are recognized, respected, and shared in a manner that respects their indigenous origins.

End Profit-Driven Eating Disorder Treatment and Non-Profits

We demand an immediate end to the monopolizing of eating disorder treatment centers and the influence of private investors within the industry. We also call for an end to ineffective and detrimental eating disorder nonprofits. The continued appointment of white professionals, as well as tokenized and conformist BIPOC individuals, does not constitute genuine change. We advocate for the dismantling of these organizations and the redistribution of their wealth and resources to community-led initiatives.

The commercialization and consolidation of treatment centers have resulted in a lack of diversity, limited options, and compromised quality of care. This monopolistic control hinders innovation, limits accessibility, and prioritizes profit over the well-being of individuals.

Private investors should not have undue influence over treatment protocols, decision-making processes, or the overall direction of eating disorder treatment centers. Lucrative wealth-producing eating disorder treatment centers should not exist. The primary focus should always be on providing comprehensive, evidence-based care that is tailored to the individual's needs, rather than maximizing financial returns.

We call for a decentralized landscape of eating disorder care ensuring a range of options that cater to different needs, preferences, and cultural backgrounds. This includes supporting community-based initiatives and decentralizing privatized and neoliberal healthcare.

Furthermore, we demand transparency in the ownership and funding structures of treatment centers. Individuals seeking care and their families have the right to know who holds financial stakes in these facilities, as this can impact treatment decisions and potential conflicts of interest.

Profit within the treatment industry often compromises the quality of care and places financial gain above the well-being of staff and individuals seeking recovery. Ineffective and harmful eating disorder nonprofits may perpetuate outdated or harmful treatment approaches, lack transparency in their operations, or fail to adequately address the diverse needs of individuals with eating disorders. “Well-meaning” nonprofits will no longer go unaccountable for their practices and their negligence towards ethical practices.

Embrace Losing Power

We demand that dominant figures within the eating disorder treatment world relinquish their power, cease centering themselves, and put an end to resource hoarding. The existing power dynamics in the industry perpetuate inequalities and restrict the representation and perspectives of marginalized communities. We call upon those in positions of influence and power to step back from their positions of powers and actively cultivate an environment that prioritizes the voices of diverse communities, particularly those from marginalized identities. This entails surrendering platforms, amplifying marginalized voices, and acknowledging the invaluable expertise that emerges from lived and living experiences. By challenging and dismantling power structures, we can foster a more equitable, and transformative eating disorder treatment industry.

Dismantling Power Dynamics Between Providers and a Clients

We call upon all providers to critically examine and reshape the prevailing power dynamics and hierarchical structures inherent in the provider-client relationship. The excessive pathologization of clients and their experiences must cease. We demand an end to the over-diagnosis and excessive prescription of psychoactive drugs. Additionally, it is imperative to eliminate preconceived notions that label individuals living with eating disorders as pathological liars and attribute every challenge they face to the so-called "eating disorder voice." People with eating disorders deserve dignified care. 

Livable Wage and Ethical Treatment of Workers

We demand that the eating disorder recovery industry ensure livable wages for all workers. It is crucial to recognize the value and expertise that professionals bring to this field and provide them with fair compensation. Additionally, we demand an end to unethical treatment practices, such as overburdening workers with excessive caseloads, lack of support and supervision, and inadequate self-care resources. It is vital to prioritize the well-being and rights of the workforce that supports individuals in their recovery journeys. 

Hiring BIPOC staff is Not Enough

It is imperative to acknowledge that the act of hiring BIPOC staff is a significant step, but it is not enough. It is crucial to recognize that hiring BIPOC staff cannot be treated as a superficial or tokenistic change. Efforts must go beyond surface-level representation. Disintegrating white supremacy requires those with the most power to do an immense amount of work including actively interrupt cycles of oppression. BIPOC should be in the entire structure. BIPOC staff should not be the only ones left with the responsibility of creating change. It is essential that BIPOC staff members feel a sense of belonging, are free to express their voices, and are not disproportionately burdened with responsibilities.

Power To The Workers! Horizontalize Organizations

We also urge eating disorder treatment centers to become union and cooperative friendly. Workers' rights and fair labor practices are essential for creating a supportive and sustainable treatment environment.

Treatment centers should respect the rights of their employees to organize and form unions, ensuring fair wages, reasonable work hours, and safe working conditions. By fostering a union-friendly environment, staff can become empowered to advocate for their rights and contribute to the overall well-being of both workers and clients.

Additionally, treatment centers should explore non-hierarchical cooperative models where workers have a voice in decision-making processes and a share in the ownership or management of the center. Cooperatives promote a more democratic and participatory workplace, fostering a sense of shared responsibility and collaboration among staff members.

Awareness of Local Impact

We should alwaysTreatment centers must be mindful of the impact they have on the communities they are situated in. This includes engaging in responsible and respectful practices that prioritize collaboration and partnership with local residents and organizations. Treatment centers should actively seek to contribute positively to the community by supporting local businesses, creating employment opportunities, and collaborating with community-led initiatives.

End​​ Gentrification

We further demand an immediate end to the gentrification of communities that eating disorder treatment centers occupy. Gentrification displaces and marginalizes local residents, disrupts community cohesion, and exacerbates existing social and economic inequalities. Recognizing one's privilege and whiteness should always be accompanied by an ongoing commitment to self-awareness and understanding their impact in different spaces.

Furthermore, treatment centers should ensure that their presence does not lead to increased property values, which can result in the displacement of long-term residents. It is essential to engage in meaningful dialogue with community members, listen to their concerns, and actively work towards solutions that benefit the entire community. 

Divest From Eating Disorder Recovery Evangelism

We demand that eating disorder treatment centers immediately divest from eating disorder recovery evangelism. Recovery evangelism refers to the imposition of specific belief systems, moral judgments, or rigid expectations on individuals seeking treatment for eating disorders. Their focus tends to be solely on constructing support systems for individuals who are actively pursuing recovery, without considering those who are struggling and considering the broader spectrum of experiences and challenges. It is crucial to create an environment that respects and validates diverse perspectives, experiences, and personal beliefs.

Individuals seeking treatment should not be subjected to one-size-fits-all approaches or pressured to conform to specific recovery narratives. The eating disorder care journey is highly individualized, and what works for one person may not work for another. It is essential for treatment centers to adopt a non-judgmental and non-coercive approach that recognizes and honors each individual's autonomy, agency, and personal values.

End the Cult-Like Features of Treatment Modalities, Centers, and Authority Figures in the ED Industry

Cult-like tendencies within the realm of eating disorder treatment can manifest through excessive control and manipulation of patients, rigid adherence to specific ideologies or treatment protocols that discourage independent thinking, gatekeeping education and specialist titles, an unhealthy power dynamic between leaders and patients, isolation from outside support systems, and potential financial exploitation. It is essential to promote transparency, accountability, and standards within the field of eating disorder treatment to ensure that those seeking help receive the best possible care, free from manipulation, excessive control, and other harmful practices. Ending cult-like features in these settings is crucial to fostering a culture of compassion, respect, and genuine support for individuals on their path. 

Stop Misappropriating the Work of BIPOC

We demand an end to the misappropriation of intellectual frameworks developed by BIPOC people in the eating disorder field. It is unacceptable for the industry to selectively borrow/steal concepts and theories without proper acknowledgement, credit, or understanding of their cultural and historical contexts. Corporations in the eating disorder industry have developed a troubling habit of exploiting labor from BIPOC individuals, all while cynically appropriating elements of liberation frameworks for superficial and marketing-driven purposes.

The work of BIPOC scholars and activists has long contributed to the understanding and advancement of eating disorder treatment and care. It is crucial to prioritize the voices and expertise of BIPOC individuals, ensuring that their contributions are recognized, respected, equitably compensated, and properly cited. 

Deprofessionalize Eating Disorder Care & Prioritize the Expertise of People with Living or Lived Experience

Deprofessionalization recognizes the inherent expertise that exists within individuals, their families, and communities affected by eating disorders. It emphasizes the importance of peer support, lived experiences, and diverse healing modalities in the recovery journey. We demand that the eating disorder recovery industry prioritize the expertise and perspectives of individuals with living or lived experience of eating disorders and that such knowledge will always be more valuable than learned experience. Bias evidence-based practices must be critically examined and challenged, recognizing that the experiences and needs of individuals with eating disorders are diverse and cannot be solely dictated by research alone. It is essential to listen to and learn from those who have firsthand knowledge of the challenges and nuances of living with an eating disorder.

Stop Colonizing Psilocybin 

We demand an immediate halt to the colonization of psilocybin and the disparagement of Indigenous traditional medicine in eating disorder treatment. The recent interest in psilocybin and other entheogenic substances for therapeutic purposes must be approached with caution and respect for the Indigenous cultures that have been utilizing these substances for healing and spiritual purposes for centuries.

It is imperative that the eating disorder recovery industry acknowledges and respects the Indigenous knowledge and wisdom surrounding traditional medicine practices. Indigenous communities have developed intricate and effective healing approaches that are deeply rooted in their cultural and spiritual beliefs. Disparaging or dismissing these traditions in favor of a Westernized and commercialized approach to psychedelic therapy is not only disrespectful but also perpetuates colonial patterns of erasure and appropriation.

If psilocybin or other entheogenic substances are to be integrated into eating disorder treatment, it must be done in collaboration and partnership with Indigenous communities, honoring their rights, perspectives, and consent. Indigenous voices should be centered and compensated for their contributions to the field, ensuring that their knowledge and practices are acknowledged, protected, and shared appropriately. There should be transparency around how eating disorder researchers are actually working towards the right relationship.

We call on the eating disorder recovery industry to engage in meaningful dialogue with Indigenous communities, fostering relationships based on respect, reciprocity, and collaboration. It is crucial to challenge and dismantle the power imbalances that perpetuate the colonization of traditional medicines and actively work towards decolonizing eating disorder treatment approaches.

By centering Indigenous perspectives and incorporating traditional medicine practices in a culturally sensitive manner, we can create a more holistic, inclusive, and ethical approach to eating disorder treatment that respects the diverse cultural and spiritual frameworks that have long existed.

Acknowledge and Address the Impact of Oppression

We insist that the eating disorder recovery industry facilitates open conversations about how oppression profoundly affects individuals grappling with eating disorders. Western culture has severed our ties to food and its systems, leading to inherently disordered relationships with nourishment. The path to healing for all begins with the restoration of our connection to the land, plants, and animals, thereby healing ourselves in the process.

It is unacceptable to silence the experiences of marginalized individuals and expect them to engage in treatment without addressing the systemic factors that contribute to their suffering. By creating space for dialogue and actively working to dismantle oppressive structures, the industry can better serve those seeking recovery.

Boldly Addressing Injustices and Fostering Social Change

Eating disorders are not apolitical affairs. Eating disorders do not exist in a vacuum, and they are often influenced by systemic inequalities, social injustices, and cultural pressures. From Puerto Rico to Palestine, we must openly acknowledge the presence and impact of colonialism. We demand that eating disorder treatment centers be more vocal about local and global injustices taking place in the world, not only when it is convenient or a popular move. 

Treatment centers should actively engage in conversations about social justice, equity, and human rights. They should use their platforms to raise awareness about the intersecting factors that contribute to the development and perpetuation of eating disorders, such as discrimination, colonialism, poverty, environmental racism, gender inequality, and body shaming. By amplifying the voices of marginalized communities and speaking out against oppression, treatment centers can play a crucial role in challenging societal norms and promoting a more inclusive and just world.

Engage Meaningfully in The Communities Centers Are a Part Of

Being actively engaged and contributing to the community helps foster a sense of belonging and social support, which are essential for individuals in eating disorder care. Embracing community involvement empowers individuals to not only receive support but also contribute their unique experiences and perspectives, fostering a mutually beneficial environment that nurtures growth and resilience.

Awareness of Poverty and Food Insecurity

We demand that the eating disorder recovery industry increase awareness and understanding of how poverty and food insecurity can impact someone's eating disorder recovery. It is crucial to acknowledge the complex relationship between socioeconomic factors and eating disorders, and to provide appropriate resources and support that address these challenges. By incorporating a social justice lens, the industry can help individuals navigate their recovery journeys more effectively. Treatment centers, as key players in the eating disorder recovery field, have more than enough wealth to democratize food access not only to their clients but also to the communities they occupy. 

Shared Understanding and Community-Centered Care

Grassroots eating disorder care models are gold standard care models. We demand that the eating disorder recovery industry develop a shared understanding of the various ways eating disorders show up, including in people in larger bodies and marginalized communities. Care must be tailored to the individual's unique needs and experiences, acknowledging the influence of cultural, social, and systemic factors. Care should be offered in community settings that encompass the person's support network, rather than relying solely on residential treatment centers or hospitals.

Only Providing Recovery Based Treatment is Harmful

Rehabilitation from eating disorders entails so much more than what treatment centers can provide or fully understand. We demand that the eating disorder recovery industry cease providing recovery-only outcome care as this oversimplifies the intricacies of rehabilitation and often results in carceral-like care structures. Instead, we demand treatment centers to provide harm reduction services, stop ultimatums, and comprehensive care.

While recovery is an important goal for many individuals, it is essential to recognize that eating disorders are difficult to treat, eating disorder institutional care has created a lot of harm and left many in a worse condition, and that for others, recovery is not a goal. Different individuals may define their own paths to well-being. Language and care within the industry should encompass a wider spectrum of experiences, embracing concepts such as harm reduction, radical compassion, and acknowledging the complex middle ground that many individuals find themselves in on their journey. By embracing a more non-exclusionary and nuanced understanding and language, we can validate the diverse experiences of those impacted by eating disorders and create a more supportive and validating environment.

Remove the Hierarchy of Eating Disorders and Recovery

Let us eliminate the hierarchy within eating disorders and recovery, recognizing that no eating disorder is superior or inferior to another. Recovery should not be seen as a higher moral ground. It is crucial to understand that anorexia is not the only eating disorder that poses significant risks. Equal attention and resources should be dedicated to addressing other eating difficulties commonly characterized as but not limited to ARFID (Avoidant/Restrictive Food Intake Disorder), binge eating disorders, EDNOS (Eating Disorder Not Otherwise Specified), and diabulimia.

Neurodiversity 

We must shift away from the medical model of disability and toward the neurodiversity paradigm in our fundamental understanding and treatment of the wide array of bodyminds that develop eating disorders. 

ARFID traits in particular cannot be lumped together as “disordered” when they are inherent characteristics of many neurotypes. So much iatrogenic harm is caused when neurodivergent traits become “target behaviors,” regardless of whether individuals have technically consented to this treatment plan. We must make space for folks to unpack whether that consent is resulting from coercion and exists as part of a functional mask and instead of insisting on change, teach self-advocacy skills and set people and their supports up with appropriate accommodations that will enable the possibility of self-acceptance. 

Conceptualizing eating disorders in neurodivergent brains as functional, whether stemming from an autistic special interest in nutrition or from the need to regulate stimulation, for example, is crucial if we are to avoid compounding the impact of ableism and reinforcing the mask via insistence on compliance. We must never assume manipulation or deceit; we must trust that folks are doing the best they can and examine our own expectations that they “should” be able to do better. We must also respect the ways in which neurodivergent people have learned to level the playing field in a world not built for their brains; for example: choosing certain accessible foods over others (even if we think they should have more variety) and using stimulant medication (even if we are worried about the side effects). We don’t get to decide whether the cons outweigh the pros; doing so is a direct threat to body autonomy and the reason so many neurodivergent folks decline to seek out otherwise needed medical care.

Furthermore, it is incumbent upon treatment providers to learn from neurodivergent self-advocates rather than from deficit-based research and peer-reviewed literature that only seeks to “support” neurodivergent folks in presenting as more neurotypical. Providers must identify previously overlooked neurodivergences in order to truly individualize care and understand the ways in which “evidence-based” practices are inaccessible to those with sensory processing, intellectual, social, and cognitive differences so that they can be adapted or scrapped altogether in favor of actually affirming approaches. Neuronormative frameworks and modalities should not be applied to ND folks. More importantly, neurodivergent voices must be amplified in collaborative treatment planning. 

Challenging the Authority of the DSM and BMI in Medical Practice

Let us remove the notion that the DSM (Diagnostic and Statistical Manual of Mental Disorders) is the ultimate authority or "Bible" when it comes to eating disorders. While the DSM provides a framework for diagnosis and classification, it is important to acknowledge its limitations and the evolving nature of our understanding of eating disorders. The experiences and complexities of individuals with eating disorders cannot be fully captured within the confines of a diagnostic manual.

BMI, or Body Mass Index, is not a reliable metric for evaluating or treating eating disorders. It is a simplistic measurement that solely considers height and weight, disregarding essential factors such as body composition, muscle mass, and overall health. Relying on BMI alone can lead to misdiagnoses and inappropriate treatment approaches, potentially exacerbating the physical and mental health of individuals with eating disorders. The complexity of these disorders demands a holistic and personalized approach that takes into account the individual's physical and psychological well-being, rather than solely relying on a numerical measurement that fails to capture the nuances of their condition.

Remove Mechanistic and Numerical Parameters in Recovery Definitions

It is imperative to remove mechanistic and numerical parameters like the BMI from recovery definitions. Recovery from an eating disorder is a deeply personal and complex journey that cannot be confined to rigid measurements or simplistic checkboxes. Placing undue emphasis on numbers or specific markers overlooks the holistic nature of recovery, which encompasses physical, emotional, and psychological healing. By shifting away from a mechanistic approach and embracing a more nuanced understanding of eating disorder care, we can create space for individual experiences and allow for diverse paths to healing. Recovery and eating disorder care should be defined by a person's overall well-being, self-acceptance, and their ability to lead a fulfilling life, rather than reducing it to mere numerical milestones.

We Demand Non-coercive and Non-carceral Eating Disorder Care

Coercion has no place in the treatment of eating disorders. It is crucial that the industry moves away from punitive and controlling approaches and instead adopts strategies that respect the autonomy and agency of individuals seeking care or recovery. Treatment should be based on collaboration, informed consent, and a deep understanding of the complex factors that contribute to eating disorders. By fostering a non-coercive environment, we can create a safe and empowering space for individuals to embark on their healing journey.

Harm Reduction is the Future of Eating Disorder Care

The concept of eating disorder harm reduction is an essential framework in the field of eating disorder care. It recognizes that not all individuals are ready or able to pursue full recovery immediately and aims to minimize the physical and psychological harm associated with their disordered behaviors. By prioritizing safety and well-being over rigid demands for immediate recovery, this approach offers a more compassionate and realistic path towards healing. It acknowledges that progress is not always linear and encourages individuals to take small steps towards healthier choices, ultimately promoting a more sustainable and effective path.

Consent, Agency, and Fundamental Needs

We demand that the eating disorder recovery industry prioritize consent, agency, and the fulfillment of fundamental needs. The utilization of violence and coercion in eating disorder treatment is a clear indication of the ineffectiveness of such a model. Individuals seeking support must be empowered to make decisions about their own bodies and treatment journeys. Instead of pushing individuals into recovery behaviors before they are ready, the industry should focus on providing resources and support to help them navigate their eating disorder care at their own pace.

Transparency, Patient-Informed Protocols, and Accountability:

We demand transparency in the eating disorder recovery industry, with treatment protocols that are informed by the individuals receiving care. Patients must have accessible avenues to provide feedback, voice concerns, and hold professionals and organizations accountable for their actions. Informed consent and shared decision-making should be the foundation of treatment, ensuring that individuals have an active role in their recovery process.

Conclusion

We call upon the eating disorder recovery industry to take these demands seriously and work towards meaningful change. The time for lip service and inaction has passed. Let us collectively strive for a more just and effective approach to eating disorder treatment and support, rooted in the principles of harm reduction, mutual aid, and non-coercive care that is centered on the needs and experiences of those seeking support.

Signed By:

Jeraca Gayle, PsyD @authentichello

Heather Jackson @heatherszines 

Florencia Vallejo-Ortiz @florvallejo 

Tessa Komine, MS, RDN, LD, CD

Gloria Lucas @nalgonapositivitypride

Hannah Smith, LMSW @hannah.noel.smith

Stacie Fanelli, LCSW @edadhd_therapist

Taylor Pajunen, @tayp_joy

Alishia McCullough, MS, LCMHC, @blackandembodied 

Jane Gregory Payne MD

H Coakley, MSPH, RDN @pandowellness 

Amanda de Waal, MA, RCC @amandadewaaltherapy

Megan Luybli, MS, RDN, LDN @asoftplacetolandllc

Allyson Inez Ford @bodyjustice.therapist 

Naureen Hunani @rds_for_neurodiversity

Anneka Spice @anneka.spice

Karen Geisterfer, BA, SUDCC 

Lindsey Hays, RD @kidneyconfidentRD

Rachel Shearer, BA, MSW Student 

Amy Esatto, RDN, LDN @amyesatto 

Jess Gagui, OTD, OTR/L @dr.jessg

Nicolette Guerrero, NP

Erin Hipple, MSW, MA, LCSW, PhD

and many others.