Why Anti-Oppression Therapy should be used in Eating Disorder Treatment
Introduction
Eating disorders (EDs) often reflect more than just individual struggles; they can be rooted in the systemic oppression and cultural pressures that shape our lives. Traditional approaches to treatment have predominantly focused on individual pathology and recovery, often overlooking the broader social contexts that contribute to disordered eating. Anti-oppression therapy offers a transformative approach by addressing the systems of power and inequality that disproportionately impact marginalized (or intentionally excluded) groups. But what exactly is anti-oppression therapy, and how can it reshape eating disorder treatment?
Defining Anti-Oppression Therapy:
Anti-oppression therapy is a therapeutic framework that acknowledges and seeks to dismantle the various systems of oppression—including but not limited to racism, sexism, classism, ableism, heterosexism, anti-fat bias, and cisnormativity—that affect individuals’ mental health and well-being. It recognizes that power and privilege play crucial roles in shaping our lived experiences and that healing requires addressing these larger systemic forces.
This approach centers the voices and experiences of those most impacted by oppression and works towards reducing harm caused by systemic injustice. It focuses on empowerment, social justice, and creating therapeutic spaces that affirm individuals’ identities, autonomy and lived realities. This is counter to the individualistic, patriarchal and racist origins of psychiatry and psychology.
In anti-oppression therapy, therapists adopt a relational and client-centered stance, engaging in reflective practice to continuously examine their own biases and the potential ways they may perpetuate harm. It seeks to restore agency and self-trust to clients by validating their experiences of systemic harm. This foundation of self trust fosters healthier relationships and ultimately, communities. The goal is to move beyond individualized frameworks to promote collective healing.
Why Anti-Oppression Therapy in Eating Disorder Treatment?
1: Understanding Social Context: Eating disorders do not exist in a vacuum. They often stem from and are perpetuated by societal ideals that uphold thinness, beauty, and success as measures of worth—values deeply ingrained in white supremacist, patriarchal, and capitalist systems. Anti-oppression therapy acknowledges these broader social determinants, focusing not only on the symptoms of an eating disorder but on the social forces that exacerbate disordered eating behaviors.
For example, anti-fatness—the systemic devaluation of fat bodies—is embedded in Western beauty standards and perpetuated through media, healthcare, and other institutions. For individuals living in larger bodies, treatment that does not address these external pressures can feel invalidating and incomplete.
2: Addressing Intersectionality: People of color, LGBTQIA+ individuals, disabled people, and those from low-income backgrounds are disproportionately impacted by eating disorders, yet they face significant barriers to receiving culturally competent care. Anti-oppression therapy centers these marginalized identities, offering a treatment approach that honors intersectionality—the understanding that different forms of oppression overlap and create unique experiences of marginalization.
For example, a Black woman navigating an eating disorder may experience not only the pressures of diet culture but also the additional burden of cultural stereotypes about Black women’s bodies, racial trauma, and gender-based violence. Anti-oppression therapy considers all of these layers in the healing process, recognizing that addressing only the eating disorder symptoms without acknowledging these intersecting oppressions falls short.
3: Restoring Autonomy and Agency: Traditional eating disorder treatment often emphasizes control—control over food, control over emotions, control over behaviors. While structure and guidance are necessary, many treatment models can unintentionally replicate oppressive dynamics by diminishing the client’s sense of autonomy. Anti-oppression therapy, particularly when paired with harm reduction, reframes treatment by focusing on restoring the client’s agency and ability to make informed choices about their recovery journey. A harm reduction approach, for example, does not demand immediate, absolute abstinence from disordered eating behaviors but instead works with clients to reduce harm at a pace that feels safe and manageable. This model respects the client’s knowledge of their body and life, fostering a sense of self-trust that may have been eroded by oppression. Harm reduction started in the streets and was later co-opted by public health- see the work of Shira Hassan in Saving Our Own Lives for more on this.
4: Creating Inclusive Therapeutic Spaces: An anti-oppression framework also requires that therapy itself becomes a safe and inclusive space for all clients, especially those from marginalized groups. This means actively rejecting oppressive narratives within the therapeutic space, creating room for clients to explore how racism, sexism, or ableism affect their relationship with food and body image. It also means therapists must engage in continuous education and self-reflection to ensure they are not reproducing harmful biases within the therapeutic relationship.
For instance, anti-fat bias can unconsciously seep into therapeutic work, even with the best intentions. An anti-oppression therapist would work diligently to recognize these biases and avoid pathologizing weight or food behaviors in ways that reinforce stigma or shame.
5: Long-Term Healing and Social Justice: Anti-oppression therapy recognizes that individual healing cannot be separated from collective liberation. Healing from eating disorders, in this framework, is not just about alleviating symptoms but also about reclaiming power in a world that often strips people of their sense of worth, control, and identity. As clients work toward personal recovery, they are also encouraged to understand and challenge the oppressive systems that contributed to their struggles in the first place. This approach empowers clients not only to heal but to become advocates for change, whether that’s through challenging beauty standards, advocating for fat acceptance, or working against racism and other forms of systemic injustice. In this way, anti-oppression therapy aligns with broader movements for social justice and equity.
6: Pushing back on Carceral Mental Health Care: An anti-carceral lens in Eating Disorder therapy recognizes that punitive, forced, coercive or rigid approaches can perpetuate shame, fear, loss of autonomy, and trauma–which worsen mental health symptoms and increase the risk of suicidality. By focusing on compassion, harm reduction, and collaboration, this lens emphasizes restoring agency and self-trust, allowing clients to engage in recovery without feeling controlled, threatended or punished. This can look like- utilizing non-police options for mental health crisis, not giving ultimatims to clients, and providing full, ongoing informed consent about the loss of autonomy, forced drugging and restraints that may happen if a client seeks treatment via hospitalization. Reccomeneded reading: Decarcerating Disability by Liat Ben-Moshe, A Profession Without Reasonby Bruce Levine and Decolonizing Therapy by Jennifer Mullan.
Conclusion
Anti-oppression therapy offers a necessary shift in the treatment of eating disorders by centering the experiences of those most impacted by oppressive systems. It recognizes that while eating disorders may manifest as individual struggles, they are often deeply tied to societal structures that uphold harmful standards of beauty, worth, and success. By addressing both the individual and the system, anti-oppression therapy fosters a more holistic and compassionate approach to healing, one that validates clients’ lived experiences and empowers them to reclaim their autonomy. For individuals facing eating disorders in an unequal world (aka, everyone!), this framework offers a pathway to not just recovery, but to liberation.
By adopting this approach, therapists can provide more meaningful, inclusive, and empowering care—ultimately working toward a world where everyone can live free from the harmful effects of oppression.
If this resonates with you and you want to learn more, feel free to book an intro call with me to hear about our 1-1 therapy services, clinical supervision services and more!
