Content warnings: eating disorder, weight bias
“I dream of a world free of eating disorders.“
For years, I tried to wrap my head around my personal and our collective struggles with recovery.
- Why did it take at least a decade before I received professional help with my eating disorder for the first time?
- Who even accesses/benefits from traditional recovery spaces, anyways?
(Spoiler alert: thin, white, wealthy, non-disabled, and cisgender women) - How does one recover while experiencing food insecurity, treatment-related harm, and/or identity-based trauma?
- Is the eating disorder really my enemy?
- What would it say, if it could speak?
- Why are queer and trans people more likely to experience eating disorders?
- How much are eating disorders underdiagnosed in BIPOC populations?
- Where do ADHD, autism, and eating disorders overlap?
- Why is anti-fat bias left out of DEI conversations?
- Why do medical institutions hold onto violent practices and concepts, such as BMI, ob*sity, and bariatric surgery?
- Where do diets come from? Why do we pursue them when they don’t work?
- Why are eating disorders prescribed and encouraged for fat folks?
- What support can we imagine for those who fall through the gaps in formal services?
I ask these questions because my interests in medicine, psychology, racial justice, food systems, LGBTQIA2s+ health, and my lived experience all converged at this point.
I wanted to put that painful experience behind me, but I couldn’t. See, I wasn’t satisfied with the idea of recovering as an individual, because that wasn’t justice. You know, the whole thing where I cannot be free until we are all free? Eating disorders disproportionately impact the populations in which I share salient identities.
“Eating disorders are a social justice issue.“
So when I applied for public health programs last fall, I wrote in my statement to every school: eating disorders are a public health, mental health, and health equity issue. A critical one, at that.
(I guess they believed me; I will be starting at Johns Hopkins University at the end of next month.)
The line between my roles as a current patient, former mental healthcare provider, and future public mental health professional began to blur, as I learned from the work of ED therapists, dieticians, activists, researchers, and most of all, individuals with lived experiences.
If I were to summarize the importance of this issue, it’s this: anti-fatness, racism, patriarchy, and ableism are products of white supremacy. We cannot work on undoing one without seeing how they are woven with each other.
I want to make it clear that I am far from the first to talk about the intersection of these multiple oppressions. The reason I have this vocabulary now is due to what I have learned from folks with marginalized identities, especially fat, Black femmes who originally started the body positivity movement decades ago. Since the mainstream has pushed out those for whom the space was originally created for, these conversations now happen in fat liberation, body liberation, fat acceptance, health at every size (HAES), fat activism, and fat positive movements. (The terminology varies, but for the sake of consistency, I will use “fat liberation” in this piece.)
As someone who holds straight-size privilege, I realize that I am a guest within fat liberation. I find that the best way for me to express solidarity is to amplify. I hope to create a page on my website for resources and folks to follow (stay tuned)!
I also recognize that public health and medical institutions perpetuate anti-fatness and weight-based eugenics in the name of social justice. I will be attending one of these institutions very soon. As part of this field, I see it as my responsibility to disrupt, or at least challenge these ethics.
Eventually, I befriended one of the team members at FEDUP: A Trans and Intersex Collective, which was how I was invited to attend the MEDA Conference this past week.
So, now it’s story time.
Eating Disorder Harm Reduction
It was my first time back in the Newton-Wellesley area since my college campus closed down at the start of COVID. I’m really not one to feel nostalgic, but I noted with surprise that the CVS and Peet’s Coffee stores were gone in the Ville.
The first keynote speaker was none other than Gloria Lucas of Nalgona Positivity Pride. Having attended Sage and Spoon (NPP’s BIPOC ED support group) in the past, I was immensely grateful that she was here.
I only knew a couple of people who would be attending, and I knew of a few more. Other than that, I was shocked to find myself in a large room full of thin, cis, white women, and only a couple speakers of color. I must have diversified my feed to the point where I became (blissfully) ignorant of my minority status as a NeuroQueer Asian-American. So I clung to other QT/BIPOC folks like secondary family. While we identified parts of some other presentations at MEDA that were problematic, it was so good for me to meet other folks on the same page as me.
What Gloria said made me feel more seen and invigorated than what any treatment group had done for me.
Harm reduction was a social justice movement originally started in the streets by drug users to keep each other safe. It meant healing outside of the biomedical model, and not fitting in with mental health institutions. Instead of demanding abstinence and imposing an agenda that took away personal autonomy and choice, they provided needle exchanges, supervised injection sites, and/or naloxone. Making it safer to use drugs did not increase drug use, but it did increase the quality of life and make it safer for individuals who used drugs. Now, we practice other forms of harm reduction daily by wearing a seat belt, helmet, face mask, or condom. This model could also be imagined for eating disorders.
Treatment centers are but a short-term solution, and for marginalized individuals, they can do more financial, emotional, and physical harm than good (plus, recidivism is so common). Recovery is also conceptualized in very black and white terms, while harm reduction tolerates moral ambiguity. She said that saving a life, instead of giving up on individuals who are not willing/able to recover is more than good enough. Harm reduction makes a life worth living through compassionate relationship building, pragmatic safety tips, and providing education to empower.
Borrowing from Da’Shaun Harrison’s concept of radical revisioning means that we create new support strategies beyond treatment, where the new world is one in which people do no longer desire to commit self-harm. Where eating disorder solutions centers BIPOC needs, invests in existing community networks, and furthers social justice.
Oh, Gloria presented her BIPOC ED Manifesto, and it helped me see that eating disorder solutions can be so much more than connecting individuals to treatment centers and providers. I listened to it, and every part of me longed for this world on the other side of the words. What if we included land-based healing to address intergenerational trauma? What if our institutions examined their white saviorism, carceralization, infantilization, academic gatekeeping, and medical ultimatums?
After all, what is recovery? We cannot heal under the same system that made us sick. I realized my body knew more than I gave it credit for: it understood that under colonialism, our relationships with the land and each other were broken.
But, “the treatment I long for does not exist.” Gloria still has an eating disorder, and until she no longer has to prioritize survival over recovery, the eating disorder still serves a purpose. As someone who didn’t finish community college, she didn’t learn any of this from a class or degree.
Right now, harm reduction is the only way she has. But, “BIPOC deserve more than an intervention that has been left as a last resort. We deserve more than scraps. We deserve treatment that is intentionally and beautifully put together.” (By the way, you can help her pay rent by buying Nalgona merch and joining her Patreon! I’ve included her Instagram throughout this post as well.)
Even at your worst, you are worthy of care. You are worthy of tenderness and unconditional support. You deserve to play a role in how you are treated.
The whole presentation struck such a chord within me. I guess this post is my embodied way of typing up my notes from this keynote. I long for a recovery that disrupts colonialism, embeds itself into community, heals the land, and creates a cultural revolution. Weight restoration without land restoration feels incomplete to me. But before that can happen, we have to survive. Even if we can’t access treatment, let’s do care in the streets.
Until next time,
Gloria
Sun Requiem 