Why Anti-Oppression Therapy should be used in Eating Disorder Treatment

Written by Allyson Inez Ford, MA, LPCC

Introduction: Beyond Individual Pathology

Traditional approaches to eating disorder treatment have predominantly focused on individual pathology (thoughts, feelings and behaviors) and personal responsibility for recovery- often overlooking the broader social contexts that contribute to disordered eating and accessibility barriers to recovery.

Eating disorders (EDs) often reflect more than just individual struggles; they are often rooted in the systemic oppression and cultural pressures which shape all of our lives. They can also be influenced by interpersonal and attachment trauma (another lens beyond the individual). And while thoughts, feelings and behaviors DO matter, many find this approach incomplete or lacking in terms of sustaining long term recovery. I believe that is because when we focus only on the here and now and only on individual symptoms, we miss the root of suffering.

The root of suffering looks at what is fueling the ‘disordered’ thoughts and feelings around food and body. If we don’t tend to this, over time, the symptoms of an eating disorder often re-emerge because the original wound was never addressed, honored and grieved. Anti-oppression therapy offers a transformative approach that looks underneath the surface by addressing attachment wounds from intergenerational trauma, historical trauma and the systems of power and inequality that continue to disproportionately impact marginalized (or intentionally excluded) groups. While this lens keeps marginalized folks at the center, it is for everyone- because everyone is harmed by white supremacy or toxic masculinity, even those at the very top of the privilege hierarchy.

Grasping at the root

Abolitionist, activist, and Black scholar Angela Davis famously said, “Radical simply means grasping things at the root.” She used this framing to remind us that if we want liberation, we must look beneath symptoms to the structures that create harm in the first place. The same truth applies to eating disorder healing. When we talk about “root causes,” we’re not referring to personal flaws or individual willpower. We’re naming the origin of forces that shape how people relate to food, bodies, self and others: systems like white supremacy, fatphobia, misogyny, colonial beauty standards, trauma, and economic inequality. Understanding eating disorders at the root allows us to move beyond behavior management and toward a more compassionate, justice-oriented approach to healing.

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 internalization of various systems of oppression (including but not limited to racism, sexism, classism, ableism, heterosexism, anti-fat bias, and cisnormativity) that affect all of our mental health and well-being. It recognizes that power and privilege play crucial roles in shaping our relationship to ourselves (including our bodies) and others bodies. Healing through this lens requires addressing these larger systemic forces, grieving what we lost to them, forgiving ourselves for how we’ve survived them and reconnecting with our true, authentic selves.

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 folks’ identities, autonomy and lived experiences. 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 a collaborative process that center’s the client’s goals, not the therapists. Anti oppression therapists engage in reflective practice to continuously examine their own biases and the potential ways they may perpetuate harm- both in and outside the therapeutic relationship. It seeks to restore agency and self-trust to clients by validating their experiences of systemic harm and reclaiming who we are outside of these systems. This foundation of self trust fosters healthier relationships and ultimately, communities. The goal is to move beyond individualized frameworks to promote collective healing.

*Note: “Relational” therapy has become a bit of a buzzword recently so let’s clear something up- relational therapy doesn’t mean being “relatable” to your client in the sense of knowing all the gen-z buzzwords or over identifying with your clients experiences and divulging (with no discretion) your own experiences. Relational therapy is about acknowledging that the client therapist relationship is a real relationship with its own attachment pattern and dynamic. This relationship can be used as a tool to explore how the client relates to others in their lives. It can be a space to practice asking for needs to be met, expressing feelings, feeling secure attachment for the first time, identifying projections and transference. The goal is to use the insight and experiential knowledge to inform client’s relationships outside of therapy too. It’s a psychodynamic tool that has been around for years and years- not something new and trendy from TikTok or IG.

What does anti-oppression therapy look like in practice?

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. These values are not random, they are deeply ingrained from colonization, patriarchy, 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, let’s look at anti-fatness, which is the systemic devaluation of fat bodies. It is embedded in Western beauty standards and perpetuated through media, healthcare, public transportation, and other institutions that we don’t often think twice about if we live with size privilege. For folks living in larger bodies, treatment that does not address these external pressures can feel invalidating and harmful. A specific example of this is the all to common eating disorder treatment experience of a person in higher weight anorexia (also known as atypical anorexia) being given a low calorie meal plan in contrast to their (more stereotypical) low weight anorexia peers being given a much more nutrient dense meal plan. Why is restriction okay for the person in a fat body, despite restriction being a core part of what sustains anorexia?

2: Addressing Intersectionality:

People of color, LGBTQIA+ folks, 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. Intersectionality is 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 (the over control also mirrors the eating disorder, in an ironic way). 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 brave 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, racism can unconsciously seep into therapeutic work when we overlook the Latine client with bulimia because ‘eating disorders are only for white people.’ An anti-oppression therapist would work diligently to recognize these biases and pivot the way they practice. When inevitably we make mistakes as a therapist, anti-oppression therapists also seek to repair them and acknowledge our biases when they show up. This humanizes the therapist and rejects the notion that we are experts on client’s lives (we’re not).

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. I often find that the value of activism strengthens ones committment to recovery, as recovery then has meaning beyond our own lives.

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 worsens mental health symptoms and increases 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 Reason by 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 systemic, 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 and authentic self. For people 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.

Looking for support?

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 in CA, WA, UT, FL and MD, as well as our clinical supervision services and recovery coaching options for folks worldwide. We would be honored to support you!