A new study published in the Journal of Eating Disorders challenges the dominant frameworks used to understand eating disorders (EDs). The researchers argue that conventional medical models have reinforced stigma, excluded diverse voices, and failed to acknowledge the complexity of ED experiences. In contrast, they propose a dialectical approach to knowledge production that values the interplay of different perspectives, including those of people with lived experience.
“The fundamental sense of injustice and wrongly apportioned blame in the story of Christ may be mirrored in the experiences of those with EDs feeling unfairly blamed for their illness,” the researchers write. “Individualistic narratives of health and illness might portray those who have not yet been able to recover from an ED as somehow deficient or unable to save themselves by evoking some power within, when in fact, their persisting illness may be a result of unmodifiable ecological, genetic, socioeconomic and cultural factors.”
The authors, James Downs, Marissa Adams, Anita Federici, Same L Sharpe, and Agnes Ayton, working from many locales, have produced an alternative methodology for creating knowledge regarding eating disorders (ED). This includes who gets a say in knowledge production and the method of coproducing knowledge from multiple points of view. It is born out of a need to understand the history of stigmatization when it comes to ED.
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“ In contrast, they propose a dialectical approach to knowledge production that values the interplay of different perspectives, including those of people with lived experience.”
Really? A study needs to be done to come to this conclusion? Accepting different perspectives and acknowledging and respecting others lived experience is just basic human kindness- giving others dignity.
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Basic human kindness isn’t common sense anymore because we’re living on the cusp of an anti-renaissance. Some of us have lost touch with our humanity, our hearts have turned to stone because of repeated ostracization experiences or other traumas. We need extra help and excluding us because we’re evil doesn’t serve the goal of interesting us in the inherent dignity of others. I for one appreciate this article and its critical perspective because I’m a morally retarded, paranoid narcissist.
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We readily accept blindness and deafness as sensory conditions—not psychological ones. But when it comes to taste and smell, we treat disturbances as mental illness. That’s a blind spot in itself.
Unlike vision and hearing, the sensory systems of the mouth and nose develop later, and their related language—describing texture, taste, disgust, and nausea—is far less accessible, especially in early childhood. A baby can’t say, “this milk smells disgusting” or “the texture makes me gag.” But when light hits their eyes, they can close their eyes for indication of blindness or may not respond to loud sound to show their auditory sensor or lack o. By the time the smell or taste sensory aversion becomes noticeable to parents or professionals, it’s often interpreted as psychological, simply because the person lacks the language to explain what is fundamentally a sensory failure. In contrast, sight and hearing impairments are much easier to detect and are not typically mistaken for mental health issues.
Could it be that, for some people, there is a real and total failure in how their digestive system processes food—not just metaphorically, but biologically? Life may be sweet, but perhaps not for everyone. For some, the very act of putting food in the mouth might unconsciously trigger the elimination process in ways that are dysregulated, overwhelming, and invisible to others. Because this response is not seen or easily measured, it’s often misinterpreted as psychological.
If the body, at a deep and automatic level, perceives food as a threat and reacts to protect itself, how would that person even know how to explain it—especially if they’re repeatedly told, “it’s all in your head”? We would never tell a blind or deaf person that their condition is psychological and needs cognitive intervention. But we routinely do this to people with invisible sensory failures involving taste, smell, and digestion. That mislabeling is a profound failure of understanding.
This is especially true for neurodivergent individuals, who may experience chronic food-related distress that is never recognized for what it is. I think many are often able to manage—but what about when the issue is actually so severe? What starts as a neurological mismatch with food can evolve into what we call an eating disorder. But the root may not be psychological at all—though it may become psychological through the treatment process itself.
It’s time we stop defaulting to mental illness and start asking whether we’re overlooking a real, invisible sensory condition—like full blindness or deafness in the olfactory and gustatory systems. Thinking this way may open a whole new territory of expression and understanding around this most basic human need: to eat and to eliminate. In my opinion, the failure to connect eating disorders to elimination is the ultimate oversight in understanding the condition (perhaps the extreme shame emotion involved is in this area). It’s like studying the eyes while completely ignoring that eyes are wet—a basic, obvious function dismissed as irrelevant.
And fundamentally, perhaps the reason this condition is so often seen as psychological is because language development is deeply intertwined with sensory experience. Without the ability to describe what is felt, seen, smelled, or tasted, internal states remain unarticulated, often misunderstood, and misdiagnosed. This creates a double-edged sword—especially when the disruption lies in a system as vital and complex as the one that governs eating and elimination.
Unlike vision and hearing, which mature early in life, taste and smell are highly shaped by experience and continue developing over a lifetime—a distinction that is often overlooked in both science and clinical practice.
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