Systems Fail: My Path into Eating Disorder Harm Reduction

Like so many others pushed to the margins, I found myself abandoned by the very systems that claimed to offer help. Mainstream eating disorder treatment not only failed me—it made things worse. What was offered as help felt like a series of cold transactions, deeply disconnected from my reality and the complexity of my life.

I walked into treatment spaces knowing I’d have to leave large parts of myself at the door. The racial trauma, the cultural grief, the entangled threads of substance use and self-harm—none of it could be safely named, much less addressed. I feared being written off as “too complicated” or being fired as a client. My presence disrupted the fantasy that these spaces were neutral, inclusive, and apolitical. One-dimensional approaches to eating disorders is just a myth. They were simply not built for people like me.

I was expected to comply with whatever treatment plan was handed to me, rather than collaborate on something that actually fit my needs. The dynamic was clear—I was the child, they were the authority. I was supposed to enter a white & completely unfamiliar environment and somehow just blend in; expected to experience no cultural shock.

Ultimately, the eating disorder field claims you don’t have to be “sick enough” to deserve support—but if you are “too sick” for a lower level of care (maybe the only care that is accessible), you’re suddenly seen as a liability or deemed too risky for treatment.

Accessing a higher level of care often means being removed from your community and asked to pause your livelihood, career, education, or caregiving responsibilities—without any meaningful consideration of the toll that takes, or whether such a sacrifice is even realistic.

The treatment process felt like a factory assembly line—a rigid prescription—as if I were expected to heal externally and mechanically.

My own entry into these spaces mirrored what many others endure: I was asked to silence my history, flatten my identity, and accept a model of healing that viewed my complexity as pathology. Discussions of racial trauma, poverty, disability, cultural grief, or political violence were not just discouraged—they were treated as irrelevant or disruptive. I quickly learned that to survive in these spaces, I had to censor myself. My needs became liabilities.

What the field calls “resistance to treatment” is too often just a refusal to vanish—an assertion of autonomy in a system that pathologizes any deviation from compliance. The reality is that the vast majority of eating disorder care is not built for Black, Indigenous, and racialized peoples. It is not built for queer, disabled, or fat bodies. It is not built for those of us who cannot, or will not, sever our suffering from the sociopolitical conditions that produce it.

To ask for harm reduction in these settings is to be misunderstood as unmotivated or “not ready.” But what if we are not asking for less care, but more? What if the very framework of treatment is what needs radical transformation? Asking for harm reduction wasn't seen as a request for autonomy—it was read as a threat. But what if it was my voice—the only voice I had left in a system that demanded silence? What if what they called resistance was actually survival?

Providers have an inclination to quickly name real concerns as the "eating disorder voice."

Ready to move beyond

rigid eurocentric recovery models and step into a framework that actually meets people where they are at?

Harm reduction is not simply a fallback for those deemed “non-compliant.” It is a fundamentally different epistemology—one that refuses to separate individual behavior from collective conditions. It understands that healing cannot be extracted from the world we live in. It resists the demand for productivity, efficiency, and recovery timelines shaped by the logic of capitalism. It refuses the binary of sick vs. recovered. And critically, it honors the knowledge and dignity of those who are struggling.

I came to understand that the treatment I critically needed did not exist. It was not just a matter of access or affordability—it was a matter of relevance, values, and effectiveness. I felt pressure to perform recovery only to make everyone happy. This would have meant, to once again, ignore my own real feelings. The model itself was incompatible with my needs and my pace.

I see striking parallels between the systems and values embedded in Native reservations and those found in eating disorder treatment centers. In both, individuals are removed from their communities and placed under the control of predominantly white authorities who claim to know what is best. Treatment centers, much like state-imposed reservation systems, often act as agents of assimilation—reinforcing rigid norms around food and health rooted in Western modernity. The underlying message is clear: to heal is to eat “normally,” which, in this context, means to eat like the so-called “healthy Western diet.”

I do not believe that true healing can emerge from a system that remains silent on genocide and apolitical in the face of Black & Indigenous lives, and complicit in the erasure of collective suffering. I do not believe that healing can come from institutions that have historically pathologized survival as illness and conformity as wellness.

So I stopped asking for a seat at a table that was never built for me. I began building my own. One rooted in community, in truth-telling, in slow, imperfect, liberatory care. A table where we are not reduced to symptoms or diagnoses. A table that doesn’t treat resistance as weakness but as wisdom. A table where harm reduction isn’t an afterthought—it’s a guiding framework for how we care for ourselves and each other in a world that makes healing hard.

Creating spaces of harm reduction is not merely about “alternatives” to care. It is about reclaiming our right to exist on our own terms. It is about designing frameworks that make space for contradiction, grief, slowness, and survival. It is about supporting those who believe survival by any means necessary.

This isn’t just my story. It’s the story of so many who have been harmed, dismissed, or erased by institutional care. Our pain is real. Our wisdom is real. And the future of eating disorder care depends on our refusal to disappear.

This journey reminds us that we are not without direction—we carry the knowledge, talent, and creativity to carve out the kind of support this static field still refuses to offer.

We have to trust our instincts and use our abilities for the highest good. We must be courageous during these times—bold for the love of the ancients, for those we've lost to eating disorders, and for the love of our community.

I invite you to witness this journey—not as inspiration, but as proof that another way is not only necessary, but already in motion.