<p>Eating disorder treatment and recovery are often framed as matters of individual responsibility, with change positioned as dependent on the person’s motivation, insight, and willingness to recover. While agency remains important, this paper argues that such framings are too narrow and can obscure the wider conditions that shape both illness and the possibility of recovery. Drawing on ecological systems theory, ecosocial approaches to health, evolutionary psychiatry, and lived experience, this paper develops an account of eating disorders as phenomena that arise within interacting systems of biological vulnerability, interpersonal relationships, sociocultural pressures, institutional arrangements, and political economy. It argues that individualistic models of illness and recovery may contribute to shame, stigma, epistemic injustice, and what is described here as hyper-responsibilisation, particularly where care is fragmented, delayed, or unequally distributed. In contrast, an ecological perspective allows eating disorders to be understood as embodied and socially patterned forms of suffering that cannot be adequately addressed through individual behaviour change alone. The paper concludes that if eating disorders are ecological in their production and maintenance, then responsibility for responding to them must also be ecological. Recommendations are made to support more collective, relational, and structurally informed approaches to prevention, treatment, and recovery.</p>

错误:搜索内容不能为空,请输入英文关键词
错误:关键词超出字数限制,请精简
高级检索

Collective responsibility and ecological thinking in eating disorders: moving beyond individualistic models of illness and recovery

  • James Downs

摘要

Eating disorder treatment and recovery are often framed as matters of individual responsibility, with change positioned as dependent on the person’s motivation, insight, and willingness to recover. While agency remains important, this paper argues that such framings are too narrow and can obscure the wider conditions that shape both illness and the possibility of recovery. Drawing on ecological systems theory, ecosocial approaches to health, evolutionary psychiatry, and lived experience, this paper develops an account of eating disorders as phenomena that arise within interacting systems of biological vulnerability, interpersonal relationships, sociocultural pressures, institutional arrangements, and political economy. It argues that individualistic models of illness and recovery may contribute to shame, stigma, epistemic injustice, and what is described here as hyper-responsibilisation, particularly where care is fragmented, delayed, or unequally distributed. In contrast, an ecological perspective allows eating disorders to be understood as embodied and socially patterned forms of suffering that cannot be adequately addressed through individual behaviour change alone. The paper concludes that if eating disorders are ecological in their production and maintenance, then responsibility for responding to them must also be ecological. Recommendations are made to support more collective, relational, and structurally informed approaches to prevention, treatment, and recovery.