Abstract
There is a growing body of qualitative research into women’s experiences of recovery from an eating disorder, however, as yet there has been little attention to the gendered social dimensions of these experiences. This in-depth interview study with eight recovered women was informed by the feminist concept of situated intersubjectivity, which allows for attention to both the discursive and material/lived dimensions of women’s experiences, as well as the intersubjective gender relations framing these. Narrative–discursive analysis revealed three main themes in women’s narratives, namely, recovery as a journey, turning points to recovery, and transforming relationships. Analysis demonstrated how many women’s accounts took the form of quest narratives, drawing on humanist discourses and practices of self-care and self-discovery to construct recovery as a journey to self. However, the study particularly identified shifts in intersubjective gender relations across women’s narratives that enabled other ways of belonging, recognition, self-acceptance, and agency. This article examines the implications of these findings for social workers and other health-care practitioners who support women experiencing eating disorders.
Introduction
Eating disorders are associated with relatively poor treatment outcomes and low rates of recovery, yet in spite of this, many women do recover and not necessarily with the help of formal therapy (Ben-Tovim et al., 2001). Given the widespread nature of eating disorders and their continuing expansion into all class (Bordo, 2004) and cultural groups (Nasser & Malson, 2009), it is more critical than ever to understand what contributes to recovery. Many quantitative studies have been undertaken in this area, and there is also a growing body of qualitative research into women’s subjective understandings and experiences of recovery. Although there is a rich body of feminist research and scholarship about eating disorders, there has been little attention to recovery from an explicitly feminist perspective. This article reports on a narrative–discursive study that aimed to explore the gender and other social dimensions of recovery from an eating disorder and the implications for social workers and other health-care practitioners who work with women in this area.
Recovery From Eating Disorders
As noted earlier, most research into recovery from eating disorders is quantitative and involves outcome studies of common treatments such as weight gain programs, cognitive–behavioral therapy, and family therapy. Recovery is defined in very specific terms in this research, relying on predetermined definitions of both an eating disorder and of what constitutes recovery. For example, Herzog et al. (1999) defined recovery as an absence of symptoms for eight consecutive weeks while others have used criteria such as body weight, symptom severity, eating attitudes, and menstruation (D’Abundo & Chally, 2004) or diagnostic criteria (Ben-Tovim et al., 2001). In the widely reported outcome study by Ben-Tovim et al. (2001), recovery rates of 56% for anorexia, 74% for bulimia, and 78% for eating disorder not otherwise specified were reported, with no difference in outcome according to whether women receive treatment or not (Ben-Tovim et al., 2001).
In an effort to understand women’s own experiences of recovery, the last few years have seen a growth in qualitative research in this area. In Norway, Pettersen and Rosenvinge (2002) interviewed and surveyed women who had experienced eating disorders, identifying self-acceptance, not using food to solve problems, and improved interpersonal relationships as central to recovery in this study. Numerous other qualitative studies emphasize similar elements, particularly self-acceptance and supportive relationships (D’Abundo & Chally, 2004; Matusek & Knudson, 2009; Patching & Lawler, 2009; Tozzi, Sullivan, Fear, McKenzie, & Bulik, 2003), moving from pleasing others to focusing on one’s own needs (Bjork & Ahlstrom, 2008; Lamoureux & Bottorff, 2005; Weaver, Wuest, & Ciliska, 2005), conflict resolution skills (Patching & Lawler, 2009), and “informed self-care” (Weaver et al., 2005, p. 197). Lamoureux and Bottorff (2005) suggest that women move from no sense of self to becoming “the real me.” Although these studies draw attention to the significance of changes in sense of self, agency, and interpersonal relationships in recovery, there is little attention to the social dimensions of these processes, with the focus primarily on intrapsychic factors. These studies also allude to gendered experiences and relations but do not elaborate them as such, including women feeling that the only meaningful thing about them is their appearance (D’Abundo & Chally, 2004), feeling caught up in pleasing others (Bjork & Ahlstrom, 2008; Weaver et al., 2005), interpersonal abuse (Lamoureux & Bottorff, 2005), and over-control by parents and boyfriends (Patching & Lawler, 2009). Related to this, there is no attempt to explore how gender might also frame recovery.
Because eating disorders are so disproportionately experienced by women (American Psychiatric Association [APA], 2013), there is a substantial body of feminist research in this area. Feminist scholars have looked to the cultural meanings of food and the slender female body in western culture, drawing attention to the conflicted and contradictory nature of femininity and its symbolization in the pursuit of thinness (e.g., Bordo, 1990, 2004; Lester, 1997; MacSween, 1993; Malson, 1998). Most well known is the seminal work of Bordo (1990, 2004), who argues that eating disorders reflect deep-seated cultural fears about femininity but also shows how thinness is appealing to women because it promises masculinized autonomy, power, and control. In another early pivotal feminist work elaborating the theme of gender contradictions, MacSween (1993) argues that the body practices associated with anorexia can be understood as “an attempt to resolve at the level of the individual body the irreconcilability of individuality and femininity” in contemporary western culture (MacSween, 1993, p. 252). Over the last decade, feminist anthropologists have also contributed to understandings of eating disorders. For example, Warin (2010) has shown how anorexia is embedded in social relatedness, including moving in and out of belonging with others and one’s body. Although the contribution of feminist research to understanding eating disorders has been enormous, as yet there has been little dedicated attention to recovery. One exception is feminist anthropological research conducted by Garrett (1998) in Australia after the author herself recovered from anorexia. Her research showed that recovery is a spiritual experience for many individuals that involves reconnecting the self with the body, society, and nature (Garrett, 1998). Garrett (1998) explored the connections between anorexia, gender, and spirituality but the gendered relations in women’s day-to-day lives were not particularly examined. My research also adopted a feminist theoretical frame but aimed to more explicitly situate women’s experiences in day-to-day intersubjective gender relations, discourses, and practices.
Method
I undertook an in-depth interview study with 14 women exploring how they understood and experienced the emergence of an eating disorder in their lives over time and, if they saw themselves as having recovered, the processes involved in this. As noted, the study was informed by a feminist theoretical perspective. Historically, feminist research has tended to focus on either the discursive aspects of women’s subjectivities or their lived experiences. I was interested in both, that is, in how women “talk about their experiences and actually live those experiences” (Gavey, 2005, p. 97). In line with this, the study was theoretically informed by McNay’s (2004) concept of situated intersubjectivity, which understands the discursive dimensions of identity and the intersubjective material power relations of daily life as inherently intertwined. The study therefore drew on post-structural feminism and Foucauldian understandings of discourse and power, as well as material feminism through its attention to gender power relations (McNay, 2004). A narrative–discursive interview method was chosen as the appropriate research methodology because it enables attention to discourse and multiple identities along with the more continuous aspects of lived narratives over time (Taylor & Littleton, 2006, p. 25) and their historical and social contexts (Riessman, 2008; Taylor & Littleton, 2006). Eating disorders usually emerge over many years so there are continuous elements to the subjectivities involved. Although the study had a particular focus on gender, it also attended to race and class and how these influenced women’s experiences of recovery.
The 14 women participating in the study self-identified as having experienced an eating disorder and were aged between 19 and 49 years, with eight of the women describing themselves as recovered. The women were recruited from the general community and a university campus via advertisements so that the sample was diverse in terms of type of eating disorder as well as the class and cultural backgrounds of the women, although all the women were from European backgrounds. The study was open to women and men, but only women volunteered to participate. The types of eating disorders experienced by the recovered women were mixed with five experiencing anorexia, two bulimia, and one both anorexia and bulimia. Half of the recovered women identified working class backgrounds and half middle-class backgrounds and two were from non-English speaking backgrounds (second generation Eastern European and third generation Southern European). I used a relatively unstructured approach to interviews so that women were given the opportunity to construct their narratives in the way they preferred, and I commenced by asking them to tell me about how the eating disorder emerged in their life, their experiences of the eating disorder itself, and their experiences of recovery. The interviews ran for between 1 and 2 hr and were conducted either in my university office or in the women’s homes depending on their preference. They were digitally recorded and transcribed verbatim. The study was approved by the University of South Australia Human Research Ethics Committee, and informed written consent was sought prior to participation.
The first step in analysis of the data involved rewriting the women’s stories into biographical accounts so that their overall structure could be examined (Riessman, 2008). This involved summarizing each biography as a whole in order to uncover the overall story of recovery, the causal relationships between the different elements as constructed by the participant and any shifts in the narratives (Riessman, 2008). In the next step, I undertook a thematic analysis of the data, identifying the main thematic categories across the accounts (Braun & Clarke, 2006) and their historical and social contexts (Riessman, 2008). Achieving rigor during data collection and analysis included using verbatim transcripts of the interviews, and reading and rereading the interview data to ensure biographies were accurate and that themes and subthemes provided a fair representation of participant meaning in line with the interpretive approach of the study (Riessman, 2008). I also used NVivo to manage this process of thematic data categorization. I was guided by the Foucauldian-informed discourse analytic process outlined by Parker (1992) and Burman and Parker (1993) in identifying and exploring the discourses women drew on to explain their understandings and experiences.
Results
Narrative–discursive analysis seeks to provide insights into overall narrative structure and shifts over time in the women’s subjectivities, as well as identification and exploration of discourse. As such, presentation of findings includes both direct quotes from interviews but also paraphrased material that situates extracts in relation to earlier sections of the women’s narratives about the development of the eating disorder itself and the social context. Pseudonyms have been used to protect participant identities. Analysis of the data uncovered three main themes in the women’s constructions of their recovery experiences, namely, recovery as a journey, turning points to recovery, and transforming relationships. Although each theme provides important insights into the social processes involved in recovery, embedded across all three is an overarching theme about becoming oneself in relationship and the inherently gendered nature of this. Thus, while other studies have identified the importance of relationships to the development of an eating disorder and to recovery (e.g., Patching & Lawler, 2009), this analysis reveals more specifically how shifts in experiences of gendered social control in women’s day-to-day relationships are especially important.
Recovery as a Journey
Many participants described the overall eating disorder and their recovery from it as a journey involving self-discovery and transformation. This often involved a shift across the narratives from feeling more subject to the expectations of others before and during the eating disorder to feeling less so in recovery. The metaphor of the journey was used by some of the women to illustrate this movement across time and to show how the eating disorder played an important role in making them the individuals they now are. Many of the accounts presenting recovery as a journey took the form of “quest narratives.” In this style of narrative, illness is portrayed as a major personal challenge requiring the individual to be “more than she has been” (Frank, 1995, p. 128). Along these lines, Rebecca presented her recovery from an eating disorder as a “healing journey” that enabled her to develop a new pathway in life as a “self-healer”: I worked consciously with yoga and meditation over a period of, probably a year, and then it all [the bulimia] just stopped … I’ve had to take an alternative path … So, in the end it sort of propelled me on this path of self-sufficiency in being able to heal myself, knowing the avenues that I needed to take, and knowing what I could do to heal myself. (Rebecca)
I don’t regret my eating disorder, as funny as it sounds because it’s made me the person I am. It’s really opened my eyes to, I believe, what life is about, and I just learnt so much from it, and I don’t regret it.
You feel like you’ve actually gained in the end?
Yeah, in the end, yeah, yeah I do … We all learn in ways, and that was my way of learning. (Carole)
By portraying the eating disorder as “my way of learning,” it becomes almost inevitable and something from which Carole ultimately benefited. Other participants also presented their eating disorder as involving positive aspects because it contributed to self-development: Jade describes the “whole journey” of the eating disorder in this way given her conflicted family situation but she also claims that it “made me who I am”: Just that whole journey from a young age was just so crazy and out of control, you know, and so many times of feeling unsafe and insecure and scared and worried. I think I was bound to fall into some sort of depression after all that and questioning myself and who I am … but you know I’m thankful for all the experiences because it’s made me stronger and it’s made me who I am now and I’ve learnt so much from it all. It’s made us stronger now as a family too … after all the bad stuff we’ve all come out a lot better and happier for it. (Jade)
Like Carole, Jade expresses gratitude for the experience because of the learning and development she believes it has brought her and her family. Garrett (1998) also found that women were grateful for their eating disorders. In a broader way, Jane described the experience of anorexia as a rite of passage for many women, not just herself, at this particular sociohistorical juncture: It’s like you’re dissembling, breaking yourself down and reassembling yourself the way you want to be. And a lot of people have described it as a kind of rite of passage, kind of like men go off to war, women go off to starve themselves to death and come back again, sort of thing. (Jane)
The concept of mental illness as a journey is central to the discourses that have emerged from the recovery movement over the past two decades, which emphasize living a meaningful life in spite of the presence of symptoms (Deegan, 1996). The women’s approaches were more reflective of traditional notions of a relatively complete return to previous functioning, though (Davidson, O’Connell, Tondora, Lawless, & Evans, 2005). Other qualitative studies have similarly emphasized the unique nature of recovery from an eating disorder compared with other mental illnesses, where the disorder seems to become no longer part of a woman’s life (Bjork & Ahlstrom, 2008; Lamoureux & Bottorff, 2005). However, not all depictions of recovery were presented in this way. Julie described a middle class family background and portrayed anorexia and thinness as part of striving for social status (Darmon, 2009). She showed me photographs of herself when she was thin and the large house and fashionable clothes she had possessed during this time. Although she described eventually recovering with the help of an understanding psychiatrist, she expressed intense regret over the “wasted” years: I think about all that time that I wasted. It was such a friggin’ waste of life I put myself through. And I tell you I’ve got irritable bowel syndrome really bad now and that was another thing that came of it, the rotten teeth and the irritable bowel. (Julie)
Turning Points to Recovery
Turning points to recovery from an eating disorder have been identified in a number of previous studies (D’Abundo & Chally, 2004; Garrett, 1998; Matusek & Knudson, 2009; Pettersen & Rosenvinge, 2002). In a continuation of the self-development focus in the women’s depictions of recovery as a journey, the accounts of turning points also initially emphasized the need to be self-reliant, but as the analysis progressed, shifts in the relationships in the women’s lives became more prominent. Along these lines, Rebecca traced her turning point to the decision to leave psychiatric care. Earlier in her narrative, she described growing shame and discomfort with her body after childhood sexual abuse, and declining confidence and self-esteem during adolescence as her parents (particularly her father) sought to impose a nonsexual, self-less femininity in ways Rebecca saw as emotionally abuse. Striving for thinness through starvation, then bingeing and purging, became ways of managing the conflicted emotional distress of trying to forge her own identity at the expense of displeasing her parents, closely echoing the theme of contradictory femininities in eating disorders proffered by key feminist theorists (Bordo, 1990, 2004; MacSween, 1993). Rebecca went on to say how her psychiatrist would not acknowledge the relevance of these experiences to her eating disorder, though: I couldn’t get through to him. He just wouldn’t listen to me. He didn’t go into the emotional abuse, nothing. He didn’t say anything to them [my parents], and I went out then, and I thought, ‘I’m never coming back’, and I never went back … But the clincher was probably [that] he said, ‘you know, I see young women like you every day who are doing this bingeing and vomiting five, six, seven, eight, nine, ten times a day’. In other words, you don’t really have that big a problem … [So] when I left the medical profession, I thought ‘OK, I don’t have any lines of support there’. So, I thought ‘OK, I’ve got to do this myself’. (Rebecca) I wanted that tablet to cure me, and I wanted that counsellor to cure me. And then I realized they couldn’t cure me, that there was no magic pill, that I had to do this, and I was the only one that had the ability to do this … I had to accept and change my thought patterns or I was going to be unwell for the rest of my life … You have to take that responsibility and make that decision, whether you want to be a victim in life and suffer. (Carole)
One of the key turning points to recovery identified by Jessica involved moving to a new school and making friends. Jessica had presented her anorexia in two main ways. First, she described refusing to eat at the family dinner table as a way of rebelling against the academic pressure and control her father placed on her.
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Second, she portrayed the thinness of anorexia as a way to impress peers in an elite school for the academically gifted where she felt socially marginalized. In Jessica’s narrative, then, anorexia at least in part involved an attempt to distinguish herself and belong in an environment where she felt out of place. As noted earlier, Warin (2010) identifies themes of not belonging and feeling out of place among women with anorexia. Jessica described her turning point to recovery below: After I was discharged [from the eating disorder unit] I got into this school and that was just like the turning point. Like normal girls and boys to hang around with and be normal, and it was just great … And then, I just started to think anorexia is actually really boring now, I just can’t be bothered … And so, it was just like a light switch. And then, so, I’m just like, ‘right, well, OK, that’s that then, I’m finished with that. We’re done’. And then I just started eating. (Jessica)
Transforming Relationships
Once turning points were reached, many women described changes in the relationships in their lives. This included finding more accepting, less conditional relationships, changing problematic relationships, and refusing relationships they saw as abusive or conditional. In stark contrast to the rape and emotional abuse by her previous husband, Carole described the relationship with her current husband as an important part of her full recovery: she said, “he’s the only person that has ever really loved me for just being me, faults and all. There’s no conditions, he accepts me.” Not dissimilarly, Jane said of her partner, “the one thing I do really like about him is no matter what weight I am, he just treats me exactly the same.” Not dissimilarly to Carole, Helena also emphasized an accepting relationship with her husband as an important aspect of her recovery. Again, the women’s narratives captured this sense of belonging and acceptance from others as part of recovery.
Jade set her experiences of recovery against a background narrative of social disadvantage, family conflict, and neglect leading to feelings of isolation and unworthiness. She described how her brother coped by retreating into his studies, while she began to diet, binge, and purge after reading women’s magazines and admiring the thinness of the celebrity women and the wonderful lives they seemed to lead. She also talked about attempting at this time to fit in with a boyfriend and other girls who also seemed to value appearances. Later, Jade elaborated how her current boyfriend’s love as well as relationships with “people that actually mattered” to her enabled her to “just be completely me” rather than seek social acceptance and belonging through thinness: Being with someone who loved me so much, I suppose that also helped because I felt I could just be completely me and that was like a wake-up call, you can still be you and feel loved. I think it just starting to feel comfortable with myself like, as I got older I was getting to know myself and feeling more confident and caring less about what other people think. Yeah, just getting a better sense of who I am and stronger relationships with people that actually mattered to me as well. (Jade)
Rebecca and Carole mentioned becoming more assertive in their relationships as part of full recovery. Earlier in her narrative, Rebecca described her parents’ attempts to impose traditional gender expectations as leading to low self-esteem and bulimia. Later, she tied her full recovery to challenging these practices: I continued to battle this low self-esteem and I said [to my parents], ‘you have to change the way you relate to me, otherwise I’m out of here and you will never see me again’. And they changed, they started changing. I became more empowered. I learnt about saying ‘stop, OK, this is how I am feeling, and you are actually treating me in a disrespectful way and I am not going to allow you to do this to me anymore’. (Rebecca) The way she’d been with me as a teenager, the spitefulness and that dangling her affection, she actually [started doing that] to my daughter. I could see she was, and that was what basically sort of cut the cord with me … and I just said to her, ‘No more’ … and that was it, there’s been no contact since … And it’s helped me immensely, cutting her out of my life. (Carole)
Discussion
Many women in this study constructed their experiences of recovery from an eating disorder as personal quests framed around themes of self-discovery, self-care, and agency. As noted in the analysis, the women gave more humanistic accounts of recovery than the participants in Garrett’s (1998) research, however, Garrett specifically recruited individuals who had an affinity with her own story of recovery as a spiritual journey. This is not to say that the journeys of the women in my study were not spiritual: they were in the sense of existential growth and a deeper awareness of self and life, if not in terms of religion and non-worldly realms. Thus, an important finding of the study is that the experience of an eating disorder can include positive aspects, as has been found in other research (e.g., Garrett, 1998; Patching & Lawler, 2009). At the same time, though, and consistent with the theoretical lens of situated intersubjectivity (McNay, 2004), the analysis captured shifts across time in the intersubjective gender relations in the women’s lives. Thus, while many of the women described recovery as finding new, more satisfying ways of belonging, being recognized, and exercising agency, these were often set against a backdrop of specifically gendered experiences of feeling they did not belong, were not recognized and gendered social practices and relations that funneled agency in particular directions. These experiences included highly gendered feelings of shame, guilt, and responsibility for sexual abuse alongside contradictory feelings of powerless and lack of control in relation to this experience; conflicted experiences of trying to forge self-identity at the expense of displeasing others; feeling obliged to meet others’ expectations or put others’ needs first; or social acceptance that seemed conditional on physical appearance rather than other dimensions of self. Sometimes the women understood their experiences as abusive, sometimes they did not. But most narratives nonetheless captured the everyday nature of the highly gendered and often conflicted discourses, practices, and intersubjective relations that frame eating disorders (see Bordo, 1990, 2004; MacSween, 1993), and how the emotional distress produced by these can lead to starving, bingeing, and purging in the pursuit of self-worth through thinness (Moulding, 2015). In contrast, recovery involved drawing on other less conflicted, less problematic discourses and practices of selfhood and self-care that are accessible to either (or any) gender in contemporary western societies and sit outside the gendered intersubjective relations implicated in eating disorders.
As noted earlier, much previous research into recovery from an eating disorder overlooks gender by presenting shifts in sense of self only in terms of individual intrapsychic factors, resulting in gender-neutral accounts that obscure the everyday gender relations in women’s lives. What this research instead shows is that such shifts have a specifically gendered character for many women that plays out in their everyday relationships. Thus, while other research has focused on the importance of relationships in eating disorders and in recovery, particularly family relationships, most of this work positions these in the personal rather than the sociopolitical realm. This analysis has instead focused on the gendered dimensions of women’s everyday relationships and how shifts in these are central to shifts in sense of self and recovery. Interestingly, like much of the literature in this area, most of the women also talked about their relationships as personal and individual while only the cultural preference for a thin female body was located as the social context for their eating disorder. I therefore argue that understandings of the sociopolitical dimensions of eating disorders need to extend to the different forms of gendered social control and power relations (including abuse) that women experience in their day-to-day lives, including in their families.
This analysis has primarily concerned itself with gender but, as noted in the findings, class was also important. For Carole and Jade, class did not explicitly feature in their narratives of recovery other than perhaps as another hurdle to achieving a sense of worth. For Jessica, leaving the privileged environment of an elite school where she felt out of place and making friends in an ordinary high school was important to belonging, recognition, and agency. In Julie’s narrative, social drift (Meadows et al., 2007) was central to the way recovery became the replacement of one set of problems (the eating disorder) with another (those of social disadvantage and poor health). Julie’s narrative offered a quite different view of recovery from the other accounts with their themes of progress and self-development: it was impossible to see Julie’s experiences in this light even though she had technically recovered. This draws attention to the significance of class in eating disorders, its shifting nature across a life course and its capacity to produce highly diverse experiences.
The findings of this study have a number of implications for social workers and other health-care practitioners. Notably, a number of women’s recoveries took place outside formal health care and included various self-help therapies. This draws attention to the importance of women having control over treatment and the fact that it is probably not the specific type of therapy per se that is critical (Garrett, 1998). This is not to say that there is no place for formal therapy; rather, it points to the importance of accepting and empathic therapeutic relationships (Bland, Renouf, & Tullgren, 2009) where women feel they have some control and choice. At the same time, though, eating disorders have a high mortality rate and can be severe (APA, 2013), and it is therefore sometimes unavoidable that client choice is compromised. Nonetheless, enhancing choice and agency remain critically important, particularly since feelings of lack of control are common in eating disorders and the women’s sense of themselves as agentic and powerful have been shown to be so important to recovery. The findings also specifically highlight the need for feminist-informed practice that helps women explore the meanings of an eating disorder in their particular lives and is empowering in helping them develop the respectful, caring relationships that are essential to mental health and well-being (Bland et al., 2009). Thus, the findings highlight the importance of practitioners approaching the relationships in women’s lives as inherently sociopolitical, rather than simply personal and individual, as part of supporting women in recognizing gendered social control, conditionality, and abuse. The women’s emphasis on self-nurturing and acceptance of their feelings through self-care also suggests that therapeutic approaches such as Compassion-Focused Therapy (CFT), which focuses on self-compassion and the reduction of shame, could be useful (Gale, Gilbert, Read, & Goss, 2014; Kelly, Carter, & Borairi, 2014). Practices of self-nurturing and self-compassion sit in sharp contrast to the abusive relationship with the self that usually characterizes an eating disorder (see also Tierney & Fox, 2011). There is emerging evidence that CFT reduces shame and improves treatment outcomes for individuals with eating disorders (Gale et al., 2014; Kelly et al., 2014). The findings of this research also draw attention to the need to look beyond individual therapy to consider the prospects for the prevention of eating disorders. Interventions for eating disorders have been almost entirely individual (Moulding, 2007; Moulding & Hepworth, 2001). Yet the culture-bound nature of these disorders points to the need to challenge not only the cultural obsession with female thinness but also gendered violence, abuse, and other more subtle forms of gendered social control that have a significant negative impact on emotional well-being for many women and girls.
A limitation of the study pertained to cultural diversity in that all of the recovered women were from European backgrounds and were second or third generation Australian. As such, race did not particularly feature in their accounts of recovery. However, a number of the women who had not yet recovered had more ethnically diverse backgrounds, and these played a significant part in their experiences of an eating disorder. Future research could therefore explore recovery for women from diverse cultural backgrounds. Another limitation was that although the study was open to both men and women, only women responded. Future research could explore men’s experiences of recovery from an eating disorder and the similarities and differences to those of women.
Conclusion
This article has endeavored to examine the social dimensions of recovery from an eating disorder, particularly as they pertain to gender. As the analysis has shown, the women commonly constructed their recoveries as personal quests, drawing on humanist discourses of self-care and self-discovery that valorize individual agency and control. However, the research has also shown how recovery involved shifts in intersubjective gender relations across women’s lives that enabled different ways of belonging, recognition, and agency. This draws attention to the need for social workers and other practitioners to attend to the relationships in women’s everyday lives as part of the sociopolitical context of the eating disorder and as central to recovery. It also highlights the need to challenge through prevention not only the cultural obsession with female thinness but also gendered violence, abuse, and other more subtle forms of gendered social control that negatively impact on women’s and girls’ mental health and well-being.
Footnotes
Acknowledgments
I would like to thank the women who took part in this research study.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The author received support through a grant from the University of South Australia’s Research Leadership Development Program.