Unrecoverable? Prescriptions and Possibilities for Eating Disorder Recovery

  • Andrea LaMarreEmail author
  • Carla Rice
  • Merryl Bear
Part of the Advances in Mental Health and Addiction book series (AMHA)


Introduction: In Western psychology, post-structural feminist scholarship on eating disorders (EDs) has brought to light three key differences between critical and conventional frameworks: differences in understandings of causation and course, in conceptualizations of the normal/pathological divide, and in attendance to lived experiences as a source of scholarly and clinical knowledge and insight.

Main Body: Situating these tensions in our current cultural milieu, which imbues bodies with moral meanings, a possible next step in illuminating ED etiology and recovery is attending to embodied experiences. In this chapter, we examine tensions between biomedical discourses around health/well-being circulating in mainstream culture and prescriptions for ED recovery found in treatment settings. Stepping outside of a biomedical frame, we outline key contributions from post-structuralist feminist perspectives and offer promising directions for future research in this area: rethinking EDs in the context of biopedagogies, or the moralizing instructions for bodies and health that circulate in biomedicalized and neoliberalized contexts such as our own.

Discussion: Noting the ways in which biopedagogies for health differ markedly from instructions for ED recovery, we suggest that there exists, within biomedical treatment regimes, a biopedagogy of recovery that may contribute to the difficulty of “achieving recovery”.

Implications: For those whose bodily experiences do not fit the “expected” course of having/recovering from an ED, attempting to follow a recovery biopedagogy may bring individuals face to face with some of the problematics of (Westernized) societal expectations for “healthy bodies”.


Eating disorders Anorexia nervosa Bulimia nervosa Eating disorders not otherwise specified Biopedagogies Post-structuralism Feminism Treatment Recovery Bodies Critical theory Diagnostic and Statistical Manual 


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn, text rev.). Washington, DC: Author.Google Scholar
  2. Azzarito, L. (2009). The rise of the corporate curriculum: Fatness, fitness and whiteness. In J. Wright & V. Harwood (Eds.), Biopolitics and the “obesity epidemic”: Governing bodies (pp. 183–198). New York: Routledge.Google Scholar
  3. Becker, A. E. (2004a). Television, disordered eating, and young women in Fiji: Negotiating body image and identity during rapid social change. Culture, Medicine and Psychiatry, 28, 533–559.PubMedCrossRefGoogle Scholar
  4. Becker, A. E. (2004b). Editorial: New global perspectives on eating disorders. Culture, Medicine and Psychiatry, 28, 433–437.PubMedCrossRefGoogle Scholar
  5. Bernstein, B. B. (2001). From pedagogies to knowledges. In I. Neves, A. Morais, B. Davies, & H. Daniels (Eds.), Towards a sociology of pedagogy: The contribution of Basil Bernstein to research (pp. 363–378). New York: Peter Lang.Google Scholar
  6. Bordo, S. (1993). Unbearable Weight. Berkeley, CA: University of California Press.Google Scholar
  7. Bordo, S. (2009). Not just “a white girl’s thing”: The changing face of food and body image problems. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating dis/orders (pp. 46–59). New York: Routledge.Google Scholar
  8. Bardone-Cone, A., Harney, M.B., Maldonado, C.R., Lawson, M.A., Robinson, P., Smith, R. & Tosh, A. (2010). Defining recovery from an eating disorder: Conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity. Behavioural Research and Therapy, 48, 194–202.Google Scholar
  9. Boughtwood, D., & Halse, C. (2010). Other than obedient: Girls’ constructions of doctors and treatment regimes for anorexia nervosa. Journal of Community & Applied Social Psychology, 20, 83–94.Google Scholar
  10. Burke, E. (2006). Feminine visions: Anorexia and contagion in pop discourse. Feminist Media Studies, 6(3), 315–330.CrossRefGoogle Scholar
  11. Burns, M. (2004). Eating like an ox: Femininity and dualistic constructions of bulimia and anorexia. Feminism and Psychology, 14(2), 269–295.CrossRefGoogle Scholar
  12. Burns, M. (2009). Bodies as (im)material? Bulimia and body image discourse. In M. Burns & H. Malson (Eds.), Critical feminist approaches to eating dis/orders (pp. 124–134). New York: Routledge.Google Scholar
  13. Chernin, K. (1985). The hungry self: Women, eating and identity. New York: Times Books.Google Scholar
  14. Darcy, A., Katz, S., Fitzpatrick, K. K., Forsberg, S., Utzinger, L., & Lock, J. (2010). All better? How former anorexia nervosa patients define recovery and engaged in treatment. European Eating Disorders Review, 18(4), 260–270.PubMedCentralPubMedCrossRefGoogle Scholar
  15. Day, K., & Keys, T. (2009). Anorexia/bulimia as resistance and conformity in pro-Ana and pro-Mia virtual conversations. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating dis/orders (pp. 87–96). New York: Routledge.Google Scholar
  16. Duran, T. L., Cashion, L. B., Gerber, T. A., & Mendez-Ybanez, G. J. (2000). Social constructionism and eating disorders: relinquishing labels and embracing personal stories. Journal of Systemic Therapies, 19(2), 23–42.Google Scholar
  17. Eckermann, L. (2009). Theorising self-starvation: beyond risk, governmentality and the normalizing gaze. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating dis/orders (pp. 9–21). New York: Routledge.Google Scholar
  18. Evans, J., & Rich, E. (2011). Body policies and body pedagogies: Every child matters in totally pedagogised schools? Journal of Education Policy, 26(3), 361–379.CrossRefGoogle Scholar
  19. Evans, J., Rich, E., Allwood, R., & Davies, B. (2008). Body pedagogies, P/policy, health and gender. British Educational Research Journal, 34(4), 387–402.CrossRefGoogle Scholar
  20. Fairburn, C. G., & Bohn, K. (2005). Eating disorder NOS (EDNOS): An example of the troublesome “not otherwise specified” (NOS) category in DSM-IV. Behaviour Research and Therapy, 43, 691–701.PubMedCentralPubMedCrossRefGoogle Scholar
  21. Fedyszyn, I. E., & Sullivan, G. B. (2007). Ethical re-evaluation of contemporary treatment for anorexia nervosa: Is an aspirational stance possible in practice? Australian Psychologist, 42(3), 198–211.CrossRefGoogle Scholar
  22. Ferreday, D. (2003). Anorexia and abjection: A review essay. Body and Society, 18(2), 139–155.CrossRefGoogle Scholar
  23. Foucault, M. (1979). Discipline and punish: The birth of the prison. New York: Vintage Books.Google Scholar
  24. Foucault, M. (1980). The history of sexuality. New York: Vintage Books (Hurley R, Trans).Google Scholar
  25. Fullagar, S. (2009). Governing healthy family lifestyles through discourses of risk and responsibility. In J. Wright & V. Harwood (Eds.), Biopolitics and the “obesity epidemic”: Governing bodies (pp. 108–126). New York: Routledge.Google Scholar
  26. Gard, M. (2011). The end of the obesity epidemic. London: Routledge.Google Scholar
  27. Gard, M., & Wright, J. (2005). The obesity epidemic: science, morality and ideology. London: Routledge.Google Scholar
  28. Gremillion, H. (2003). Feeding anorexia: Gender and power at a treatment centre. Durham, England: Duke University Press.CrossRefGoogle Scholar
  29. Hardin, P. K. (2003). Social and cultural considerations in recovery from anorexia nervosa: A critical poststructuralist analysis. Advances in Nursing Science, 26(1), 5–16.PubMedCrossRefGoogle Scholar
  30. Harwood, V. (2009). Theorizing biopedagogies. In J. Wright & V. Harwood (Eds.), Biopolitics and the “obesity epidemic”: Governing bodies (pp. 16–30). New York: Routledge.Google Scholar
  31. Harwood, V. (2010). Mobile asylums: psychopathologisation as a personal, portable psychiatric prison. Discourse: Studies in the Cultural Politics of Education, 31(4), 437–451.Google Scholar
  32. Helverskov, J. J., Lyng, B., Clausen, L., Mors, O., Frydenberg, M., Thomsen, P. H., et al. (2011). Empirical support for a reclassification of eating disorders NOS. European Eating Disorders Review, 19, 303–315.Google Scholar
  33. Hepworth, J. (1999). The social construction of anorexia nervosa. London: Sage.Google Scholar
  34. Ison, J., & Kent, S. (2010). Social identity in eating disorders. European Eating Disorders Review, 18, 475–485.PubMedCrossRefGoogle Scholar
  35. Jasper, K. (2015). Feminist therapy. In L. Smolak & M. P. Levine (Eds.), The Wiley handbook of eating disorders (Vol 2, pp. 801–815). West Sussex, UK: John Wiley & Sons, Ltd.Google Scholar
  36. Katzman, M., & Lee, S. (1997). Beyond body image: the integration of feminist and transcultural theories in the understanding of self starvation. International Journal of Eating Disorders, 22, 385–394.PubMedCrossRefGoogle Scholar
  37. Lafrance Robinson A, Dolhanty J (2013) Emotion-focused family therapy for eating disorders across the lifespan. Bulletin 28(3), National Eating Disorder Information Centre, Toronto, ON, Canada.Google Scholar
  38. Leahy, D. (2009). Disgusting pedagogies. In J. Wright & V. Harwood (Eds.), Biopolitics and the “obesity epidemic”: Governing bodies (pp. 172–182). New York: Routledge.Google Scholar
  39. Lester, R. J. (1997). The (dis)embodied self in anorexia nervosa. Social Science & Medicine (1982), 44(4), 479–489.CrossRefGoogle Scholar
  40. Lupton, D. (2013). Fat. New York: Routledge.Google Scholar
  41. MacDonald, D., Wright, J., & Abbott, R. (2010). Anxieties and aspirations: The making of active, informed citizens. In J. Wright & D. Macdonald (Eds.), Young people, physical activity and the everyday (pp. 121–135). London: Routledge.Google Scholar
  42. MacNeill, M., & Rail, G. (2010). The visions, voices and moves of young “Canadians”: Exploring diversity, subjectivity and cultural constructions of fitness and health. In J. Wright & D. Macdonald (Eds.), Young people, physical activity and the everyday (pp. 175–194). London: Routledge.Google Scholar
  43. Maisel, R. L., Epston, D., & Borden, A. (2004). Biting the hand that starves you. New York: W.W. Norton.Google Scholar
  44. Malson, H. (1998). The thin woman: Feminism, post-structuralism and the social psychology of anorexia nervosa. New York: Routledge.CrossRefGoogle Scholar
  45. Malson, H., Bailey, L., Clarke, S., Treasure, J., Anderson, G., & Kohn, M. (2011). Un/imaginable future selves: A discourse analysis of in-patients’ talk about recovery from an “eating disorder.”. European Eating Disorders Review, 19, 25–36.PubMedCrossRefGoogle Scholar
  46. Moulding, N. (2009). The anorexic as femme fatale: Reproducing gender through the father/psychiatrist-daughter/patient relationship. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating dis/orders (pp. 172–184). New York: Routledge.Google Scholar
  47. Murphy, T. (2009). Technology, tools and toxic expectations: Post-publication notes on New Technologies and Human Rights Law. Innovation and Technology, 1, 181–202.Google Scholar
  48. Nasser, M., & Malson, H. (2009). Beyond Western dis/orders: thinness and self-starvation of other-ed women. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating dis/orders (pp. 74–83). New York: Routledge.Google Scholar
  49. Neumark-Sztainer, D., Bauer, K. W., Friend, S., Hannan, P. J., Story, M., & Berge, J. M. (2010). Family weight talk and dieting: How much do they matter for body dissatisfaction and disordered eating behaviors in adolescent girls? Journal of Adolescent Health, 47, 270–276.PubMedCentralPubMedCrossRefGoogle Scholar
  50. Orbach, S. (1986). Hunger strike: The anorectic’s struggle as a metaphor for our age. London: Faber & Faber.Google Scholar
  51. Petherick, L. (2011). Producing the young biocitizen: Secondary school students’ negotiation of learning in physical education. Sport, Education and Society, 18(6), 1–20.Google Scholar
  52. Pike, K. M., & Borovy, A. (2004). The rise of eating disorders in Japan: Issues of culture and limitations of the model of “Westernization.”. Culture, Medicine and Psychiatry, 28, 493–531.PubMedCrossRefGoogle Scholar
  53. Piran, N., & Teall, T. (2012). The developmental theory of embodiment. In G. L. McVey, M. P. Levine, N. Piran, & H. B. Ferguson (Eds.), Preventing eating-related and weight related disorders (pp. 169–199). Waterloo, ON, Canada: Wilfred Laurier University Press.Google Scholar
  54. Rail, G. (2012). The birth of the obesity clinic: Confessions of the flesh, biopedagogies and physical culture. Sociology of Sport Journal, 29, 227–253.Google Scholar
  55. Rice, C. (2007). Becoming the ‘Fat Girl’: Acquisition of an unfit identity. Women’s Studies International Forum, 30, 158–174.CrossRefGoogle Scholar
  56. Rice, C. (2014). Becoming women: The embodied self in image culture. Toronto, ON, Canada: University of Toronto Press.Google Scholar
  57. Rice, C. (2015). Re-thinking fat: From bio- to body becoming pedagogies. CSCM (Forthcoming).Google Scholar
  58. Rich, E. (2010). Obesity assemblages and surveillance in schools. International Journal of Qualitative Studies in Education, 23(7), 803–821.CrossRefGoogle Scholar
  59. Rich, E. (2011). ‘I see her being obesed!’: Public pedagogy, reality media and the obesity crisis. Health, 15(1), 3–21.PubMedGoogle Scholar
  60. Rose, N., & Novas, C. (2005). Biological citizenship. In A. Ong & S. J. Collier (Eds.), Global assemblages: Technology, politics, and ethics as anthropological problems (pp. 439–463). Oxford, England: Blackwell.Google Scholar
  61. Saguy, A. C., & Ward, A. (2011). Coming out as fat: Rethinking stigma. Social Psychology Quarterly, 74(1), 53–75.CrossRefGoogle Scholar
  62. Shisslak, C. M., Crago, M., & Estes, L. S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18(3), 209–219.PubMedCrossRefGoogle Scholar
  63. Shohet, M. (2007). Narrating anorexia: “full” and “struggling” genres of recovery. Ethos, 35(3), 344–382.CrossRefGoogle Scholar
  64. Steinhausen, H., Rauss-Mason, C., & Seidel, R. (1991). Follow-up studies of anorexia nervosa: A review of four decades of outcome research. Psychological Medicine, 21, 447–454.PubMedCrossRefGoogle Scholar
  65. Strober, M., & Johnson, C. (2012). The need for complex ideas in anorexia nervosa: Why biology, environment, and psyche all matter, why therapists make mistakes, and why clinical benchmarks are needed for managing weight correction. International Journal of Eating Disorders, 45(2), 155–178.Google Scholar
  66. Thomas, J., & Schaefer, J. (2013). Almost anorexic: Is my (or my loved one’s) relationship with food a problem? Boston: Harvard Health.Google Scholar
  67. van Amsterdam, N., Knoppers, A., Claringbould, I., & Jongmans, M. (2012). ‘It’s just the way it is…’or not? How physical education teachers categorise and normalise differences. Gender and Education, 24(7), 783–798.CrossRefGoogle Scholar
  68. Vesely, R. (2008). Becoming ‘biocitizens.’. Modern Healthcare, 38(50), 32–33.Google Scholar
  69. Wade, T., Byrne, S., & Touyz, S. (2013). A clinician’s quick guide of evidence-based approaches. Number 1: Eating disorders. Clinical Psychologist, 17, 31–32.CrossRefGoogle Scholar
  70. Wade, T. D., Crosby, R. D., & Martin, N. G. (2006). Use of latent profile analysis to identify eating disorder phenotypes in an adult Australian twin cohort. Archives of General Psychiatry, 63, 1377–1384.PubMedCrossRefGoogle Scholar
  71. Warin, M. (2010). Abject relations: Everyday worlds of anorexia. Piscataway, NJ: Rutgers University Press.Google Scholar
  72. Wonderlich, S. A., Joiner, T. E., Jr., Keel, P. K., Williamson, D. A., & Crosby, R. D. (2007). Eating disorders: Empirical approaches to classification. American Psychologist, 62(3), 167–180.PubMedCrossRefGoogle Scholar
  73. Wright, J. (2009). Biopower, biopedagogies and the obesity epidemic. In J. Wright & V. Harwood (Eds.), Biopolitics and the “obesity epidemic”: Governing bodies (pp. 1–14). New York: Routledge.Google Scholar
  74. Rice, C. (2009). How big girls become fat girls: The cultural production of problem eating and physical inactivity. In H. Malson & M. Burns (Eds.), Critical feminist approaches to eating dis/orders (pp. 92–109). London: Psychology Press.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Family Relations and Applied NutritionUniversity of GuelphGuelphCanada
  2. 2.National Eating Disorder Information CentreTorontoCanada

Personalised recommendations