On Productive Critique and Doing the Work in the Eating Disorders Field

There is so much to say about the ICED conference, as always. If nothing else, I can count on this conference to make me feel all kinds of ways… it’s good, bad, ugly, connected, and isolated, all wrapped into one big bow. I have been attending ICED for 5 years, and suitably my first ICED was also in NYC; it feels like a good moment to reflect and take a breath.

An image of the flatiron building in the evening.

An image of the flatiron building in the evening.

This year, I made a commitment to myself to take care of my body’s needs. This included: sleeping more, making sure to leave sessions if I got hungry and/or to prepare by bringing food along with me, only drinking coffee in the morning, missing more sessions than usual in order to be fully present in those that I did attend, and opting to socialize more one-on-one rather than doing the larger “socials” . I tried to balance my body’s not insignificant asks with a desire to show up and be present as an ally in spaces that are not always welcoming to different bodies. I was sometimes successful at both, and sometimes less so, but I am letting that go and considering how what I learned about both the content presented and about conferencing in a way that works for my body-mind.

As ever, it’s important to note that the critiques that I’ll surface in this post are systemic. Perhaps this is the case in all fields, but I only know mine. It seems that when critiques are leveraged, people automatically assume that they are being called a bad person. Public enemy number one. This is not the case. It is my true belief that people doing this work from all paradigms are good people. Generally, they want the best for people who are struggling to get by in a world that is profoundly messed up about food and bodies. They do not want people to suffer. There is often a noble goal behind the work, and sometimes the work is personal. And still, we all work within our disciplinary, personal, and social ways of knowing and doing, and we research and practice in a system that is itself grounded in hetero-patriarchy, white supremacy culture, and neoliberalism. And herein is the necessity of critique. Until we start looking at these issues as systemic, we will remain mired in petty arguments and miss reaching inside and doing the work we need to do to make change and make life better for all people who need and desire understanding.

I am also not under the illusion that my critiques are perfect, or that I am the first or best person to leverage them. Many, many people have been labouring to make change for years before me. Fat activists have paved the way for me to even begin to understand what I am talking about when I talk about weight stigma. People of colour have been saying—and living—important things that expose the problematics of social systems that uphold research and clinical practice that excludes and harms for years. Disability justice advocates have spoken out about access and inclusion in public forums for decades. We just haven’t been listening. And I am not perfect or beyond reproach, nor am I a hero for saying these things. I mess up all the time. I too feel defensive. But the fear of messing up cannot keep us from moving forward. From doing things differently. I would be lying if I said I was not afraid; afraid of publishing posts like these, afraid of speaking for others, afraid of being the squeaky wheel.

One of the most obvious tensions that comes up is that in our field, the systems have upheld the voices of white men as the ultimate “experts” on eating disorders. This has led, through replication, to white men often being the dominant voices in, for instance, plenary sessions. Removing this from the individual level is important. This is not saying that those men have not worked hard or that they do not have important things to say. And, there are also women and folks from marginalized groups (not mutually exclusive categories of course) who have important things to say as well and who have fought to have their voices and perspectives heard. We know that there are gender biases in research funding that have resulted in women not always having the funds to do the kind of research that gets attention. This is but one example of how women have been structurally held back from being at the podium.

There were some diverse, and very important, sessions at the conference. One particularly excellent workshop was about making the eating disorder field more inclusive and was led by Dr. Lesley Williams and Dr. Marisol Perez. Among the many things they spoke about, Williams & Perez spoke about the challenges of even entering the field when you are a woman of colour; and, when you do, there is a risk of being seen as an expert only about marginalized experiences of eating disorders. Which is, of course, an important expertise. But when we make marginalized folks’ expertise only about that, we neglect to acknowledge the broader experiences they hold. This session was important and highlighted how we need to be bringing diverse voices to the table—and, as Deb Burgard stated at a later session, re-shaping the tables themselves to fit those who are coming to the table—not only in sectioned-off parts of conferences. Diversity is not an add-on or a bonus. Marginalization, access, and stigma (conscious and unconscious) need to be at the forefront of our thinking.

As always, the issue of access comes up at conferences; for instance, the hotels themselves are not accessible (I struggled to get through some bathroom doorways!), and conferences are expensive. I spent over $2000 of my own money to attend this conference. I tried to Tweet as much as I could to share what was happening (through my lens, of course), but I know it is disappointing to not be able to attend conferences for financial reasons. We need to be thinking about this and considering how to open conferences up, if we wish to truly share and exchange knowledge. I know many people with lived experience and supporters in particular would love to be included. 

I am encouraged to have seen several sessions where presenters treated people with lived experience with respect and dignity, and integrated them into research design, though this was far from the norm. I also had a chance to chat with the wonderful Erin Harrop about how as researchers our bodies are always in the room, and was absolutely floored with all of the work she has been doing to incorporate this awareness and respect of participants in all of their wholeness and humanity into her studies. I was particularly buoyed by conversations I had with colleagues about how we can begin, as a field, to explore the biases we hold against people with lived experience and multiply marginalized folks. I hope that this work comes to fruition and that we continue to see change in this regard.

The final plenary session of the conference was one of the toughest, dealing with interventions to regulate emotions and to regulate binging. I went on a Twitter muse about how brains are treated as entities separate from the body and against some ideal norm, but I think a ramble on that here would take up too much of readers’ valuable time. I will instead focus on the problematics of interventions that endorse dietary restriction to “treat” binge eating disorder. Again, this is a systemic issue. The intervention presented was not that different from many others I’ve read or heard about. It would also be beyond the scope of this post to get into the complexities of the intervention described, nor do I wish to activate anyone in this space beyond the activation that may already be happening reading this post. Instead, I will quote a post I will be sharing to the AED community when I am able to access it:

“Some of the ways in which the intervention was described seemed to place restrictive behaviours at a higher moral level than binge behaviours and “emotional eating,” such that restriction (or another term use, “inhibition skills”) were seen as desirable for a subset of the population. I return time and time again to Deb Burgard’s astute observation that “we prescribe to fat people what we diagnose as eating disorders in thin people.” I find this particularly concerning in interventions that are aiming to treat eating disorders. And despite the fact that there is not a stated intention to promote weight loss, I find it hard to believe that a similar intervention would be prescribed to a client with a smaller body, regardless of reported binge behaviour. I understand how interventions like this come to be, given our cultural context around what “normal eating” could or should look like. And, I do not believe that endorsement of restriction is a good idea; there are ways of encouraging body attunement that do not require any restriction and that do not frame hunger as something to be afraid of.

Another thing to consider is the images used in the presentation, and what they symbolize. For instance, there was an image of a wrist wrapped in chains. This is the type of imagery that I might expect to see in a news story about eating disorders—which I’m sure we’ve all seen tend to sensationalize eating disorders—not at a professional conference and used to depict something positive. There were also images of fat folks depicted using the problematic “headless fatty” trope (for more on that, here is a post by Charlotte Cooper http://charlottecooper.net/fat/fat-writing/headless-fatties-01-07/), and other images that I, again, would not expect to see in a professional eating disorders conference setting.”

I realize I sound like a downer, and like I am not grateful for the opportunity to attend and present at conferences like these. This is not the case—I am incredibly grateful. I think these are conversations that need to be happening, in and outside of the field. In and outside of conference spaces, which see an attendance made up of only those who can afford to attend (on a financial, physical, psychological, spiritual etc. level). I had some amazing conversations at the conference with wonderful humans who are all working to try to make life better for people experiencing distress in their bodies and around food. There is so much power here; and there is power in the disagreement. I attended a difficult dialogues session where we were invited to try to disagree on things, and this space was one where we actually generated more agreement than I’ve seen in the past, about contentious issues. Because when we bring our disagreements, and our full selves, to the fore, we can work with that. We can move from there. Otherwise we are shouting into the void, expecting to be heard. I want to acknowledge that there is movement in the AED. There is a new Diversity & Inclusion committee, and I am eagerly awaiting hearing about ways that we can all help this committee to achieve shifts in the landscape.

So those are my Sunday afternoon rambles, as I sit in my living room on a cold March day, marinating in the post-conference feels. Thank you for listening, and I hope that we continue these conversations.