The Political and Social Biases of Eating Disorder Treatment, Part I

Not much has been written about why most people with eating disorders are women. The standard explanation is that the pressure of thinness and dieting is much stronger for girls and women. Since undereating is the number one risk factor for developing an eating disorder, this explanation has some merit. However, it feels like a facile and elusive way to understand a much more complicated situation. 

Psychiatry has often used certain diagnoses to explain women’s emotions. Hysteria, fainting spells and erotic fixation are examples of ways the mental health establishment has attempted to silence and pathologize women’s human reactions, whether emotional or sexual.

The question psychiatry and the eating disorder treatment world needs to address is whether eating disorders represent the newest way to silence women.

First and foremost, I know these illnesses are serious and real, much as the other illnesses I mention above are real. In no way do I doubt the severity of these disorders.

The problem is how psychiatry uses these illnesses to quiet women and explain away valid emotions women express.

For instance, most psychiatrists can compete their entire residency training program learning very little about how to treat people with eating disorders. This is odd considering how prevalent eating disorders are in this country. Accordingly, most eating disorder treatment exists as privatized business outside of the medical establishment and one that very often excludes the treatment of men. In fact, many eating disorder treatment programs openly endorse a feminist slant to their treatment, politicizing the existence of eating disorders. 

Sometimes, as most laypeople assume, eating disorders stem from a desire to look a certain way in order to invite attention to physical appearance. Much more frequently, eating disorders serve as a way to be more invisible either by being very underweight and resemble a young girl or by being overweight and effectively invisible in a fat phobic world.

I have written extensively about the treatment of eating disorders and said multiple times how the core of treatment involves close personal connection and that the antidote to an eating disorder is love.

These facts and treatments are very different from the treatment of any other mental illness such as schizophrenia or bipolar disorder. Clearly, there is a strong social component to this illness, and one aimed specifically at women.

The difficulty with these revelations is how to address them. I’ll write more about this in the next post.