Decolonizing Eating Disorders Through Indigenous Food Sovereignty Paradigms: A Brief Introduction

A Brief Intro
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Decolonizing Eating Disorders Through Indigenous Food Sovereignty Paradigms

A Brief Introduction

Morgan A. Hopson

Eating disorders such as bulimia nervosa, anorexia nervosa, and binge eating disorder have been predominantly diagnosed and treated under the western biomedical model of psychiatry and psychology. Despite widespread critiques of the western biomedical model of global mental health, there have been few decolonial epistemologies and methodologies applied to the etiology and epidemiology of eating disorders. Research provided by the scientific and humanitarian fields has laid out the alarming effects that eating disorders have on the global population, highlighting an increase in populations undergoing westernization. Several critical gaps and limitations of the current pathologization of eating disorders under the western biomedical models of psychiatry and psychology have been instituted by researchers in these fields, yet there are minimal solutions posited. Decolonial epistemologies and methodologies serve as a crucial contribution to the etiology and epidemiology of eating disorders through critiques of globalization, the systemic colonial institutionalization of psychology and psychiatry, and colonial social industrial complexes underpinning food systems, health care systems, and governmental policy.

Through decolonial analytics, these factors are proposed as evolutionary determinants

originating and perpetuating eating disorders as a result of settler colonialism’s influence. Also illustrated are the reasons why these determinants cannot be accurately diagnosed, researched, and treated through the colonial epistemologies of psychiatry and psychology, but instead, necessitate a decolonial methodology that addresses the gaps and limitations on a whole-systems level. Indigenous food sovereignty is proposed as a culturally appropriate and inclusive methodological framework for the diagnosis and treatment of eating disorders, filling the gaps and limitations of western biomedicine in regards to eating disorder etiology and epidemiology.

This discourse is informed through exploring the question: How can the decolonial methodology of Indigenous Food Sovereignty be utilized in response to the gaps and limitations of eating disorder etiology and epidemiology under the western biomedical models of psychiatry and psychology? Motivations for the research question arose out of the importance that decolonial epistemologies be included in all knowledge-making, and which are essential for research paradigms such as eating disorder epistemology. Eating disorders have the highest mortality rate of all mental illnesses, are increasing globally in rate, and are inseparable from globalized systems. Eating disorders have detrimental societal effects that disproportionately impact Indigenous communities because the systemic settler colonial determinants forming eating disorders correlate with cultural genocide, sex trafficking, climate change, and ecological degradation. Empirical research displaying data on these correlations is in dire need for understanding and treating eating disorders. As such, this literature provides critical contributions to an extremely vast scope of public health professionals, environmental scientists, political scientists, food systems theorists, and anyone who is a consumer or provider participating in global and local social-industrial systems. This offering contributes to the discourse on the prevention of, and restoration from, the global health and mental health crises, cultural restitution for communities affected by settler colonialism, climate solutions, socio-political and economic reform, and public health and safety.

Colonization, Decolonization, and Neoliberalism

Due to the limited nature and scope of this paper, the extremely nuanced history and complexity of colonization and decolonization are not discussed here, in entirety. For the purposes of this paper, the reference of colonization is drawn from a scope of literature that contextualizes colonization as it relates to settler colonization of land, time and place, bodies, gender, sexuality, and food systems. Through the course of dialogue in this paper, I aim to illustrate how the proposed determinants of eating disorders in the predominant research literature are stemming from settler colonialism’s influence on the factors mentioned above. For a more in-depth background on the global history of colonization, please refer to “Decolonizing scoping review methodologies for literature with, for, and by Indigenous peoples and the African diaspora: dialoguing with the tensions” (Chambers et al., 2018). For a detailed literature review on the decolonization of global mental health please see (Mills, 2014a). Setting the stage for the contextualization of colonialism and eating disorders, Patrick Wolfe defines settler colonialism as being a distinct, self-sustaining system preconditioned to expropriate Indigenous lands and resources by colonial regimes, through the elimination of Native peoples, institutionalizing the present-day multicultural neoliberal ideology (Wolfe, 2006).

Lorenzo Veracini extends the bounds of settler societies of Australia, Canada, New Zealand, and the U.S. e in his argument that the “geographical scope of this debate should be widened again, that settler colonialism makes sense especially if it is understood globally, and that we live in a settler-colonial global present” (Veracini, 2015). This extension underlines the requirement that an adequate analysis of settler colonialism’s influence on the etiology and epidemiology of eating disorders must include an innately globalized epistemology, and suggests the necessity of a shared understanding of place and time between colonial and decolonial epistemologies. Through the lenses of physics, phenomenology, queer studies, and postcolonial theory, Mark Rifkin offers a response to this call by analyzing the Indigenous experience of time and place through sovereignty and the experience of multiple temporalities in contrast with settler-colonial definitions of time and place (Rifkin, 2017). Finally, contextualizing the very bodies which are experiencing the colonization of land, time and place through an analysis of sexuality, gender, and bodies, Scott Morgensen asserts, “In the Americas, specifically, the United States, the biopolitics of settler colonialism was constituted by the imposition of colonial heteropatriarchy and the hegemony of settler sexuality, which sought both the elimination of Indigenous sexuality and its incorporation into settler sexual modernity” (Morgensen, 2011).

There is extensive literature from Queer, Indigenous, and African Diasporic authors who discuss the shaping of gender, sexuality, and bodies through biopolitics of settler colonialism in more depth, as it relates to capitalism, imperialism, neoliberal politics, and industrialization (Arvin, Tuck, & Morrill, 2013; Finley, 2011; King, 2013; Norman, Hart, & Petherick, 2019; Smith, 2010). These authors have laid the foundation for illustrating settler colonialism’s influence on land, time and place, bodies, sexuality, gender, and resources. Utilizing these decolonial epistemological lenses provides the contextualization necessary for acknowledging these factors as evolutionary determinants of eating disorders stemming from settler colonialisms’ influence. It also offers the bones of a framework necessary for applying culturally appropriate and scientifically adequate diagnoses and recovery methodologies to eating disorder epistemology. This decolonial framework fills the gaps and limitations of the predominant eating disorder diagnoses and treatment models under western colonial epistemologies. In the following paragraphs, I aim to illustrate how the western biomedical models of psychiatry and psychology hold key stakeholders invested in the perpetuation of eating disorders through their involvement in the settler-colonial social-industrial complexes that are the proposed determinants of eating disorders laid out in this paper. Finally, Indigenous food sovereignty is also proposed as a decolonial epistemology and methodology that can be applied to eating disorder etiology and epidemiology, addressing the eating disorder determinants proposed and filling the gaps and limitations of western biomedicine’s diagnostic and treatment criteria for eating disorders.

Because decolonization is as nuanced and complex as the forces of colonization, decolonization in this context will be referred to as the epistemologies, ideologies, and methodologies that aim to counter settler colonialism and it has been referenced above.

Gaps and Limitation of the Western Biomedical Model

The western biomedical models of psychiatry and psychology have been widely critiqued by both colonial and decolonial epistemologists over several decades, as they relate to global health and mental health for Indigenous, diasporic, and settler colonial communities (Benning, 2015; Blignault, Hunter, & Mumford, 2018; Karter & Kamens, 2019; Mills, 2014b; Thomas, Bracken, & Yasmeen, 2007). An epistemically colonial critique of the literature on the etiology and epidemiology of eating disorders provides a concise analysis of the gaps and limitations of the western biomedical model from within its field of neuroscience (Rikani et al., 2013). This critique includes the recognition that the bio-psycho-social determinants of eating disorders have remained inconclusive, the etiology of eating disorders has yet to be uncovered, and there has been a steady increase in epidemiology under this model. The literature also acknowledges the inability of the western biomedical methodology to address the nuances and complexities of eating disorder epidemiological factors.

The literature proposes that these failures “may be due to complexities of eating

disorders, limitations of the studies or combination of two factors” but fails to provide further reasoning or insight into these suggestions (Rikani et al., 2013). There are several other studies outlining critiques to colonial epistemologies of eating disorder diagnosis and treatment for various intersectionalities of cultures and identities (Brown, T. A., Griffiths, & Murray, 2018; Castellini, Lelli, Cassioli, & Ricca, 2019; Rundgren, 2014; Sonneville & Lipson, 2018; Venturo-Conerly, Wasil, Shingleton, & Weisz, 2019). However, none provide a comprehensive decolonial model which analyze evolutionary theory, global food systems, social-industrial complexes, and decolonial epistemologies of land, place and time, bodies, sexuality, gender, and resources in tandem. Utilizing a decolonial lens, the following sections aim to extend upon the proposed gaps and limitations and set the stage for presenting Indigenous food sovereignty as a crucial methodology for eating disorder diagnosis and treatment in response to these gaps and limitations. Scholars have explored the complexities of eating disorders through inclusivity of identity demographics in eating disorder research, the influence of settler-colonial social-industrial complexes on eating disorder etiology and epidemiology, and the socio-economic toll of eating disorders. Furthermore, these determinants are also explored as they are related to the limitations of the western biomedical model’s ability to address them. Connections are made between the global environmental crises, sex-trafficking, the delicate balance of biodiversity, and eating disorder etiology.

Inclusivity of identity demographics - Race, Ethnicity, Class, Sexuality, Ableness

One of the agreed-upon gaps and limitations for eating disorder research under the western biomedical model of psychiatry and psychology is a lack of inclusivity of identity demographics within research, diagnosis, and treatment models (Jain, 2020; Vanderlinden et al., 2020) (10, find more). Eating disorders have been historically mischaracterized as a predominantly white, middle-class women’s issue (Brown, Griffiths, & Murray, 2018; Gard & Freeman, 1996; Gordon, Perez, & Joiner Jr, 2002; Sonneville & Lipson, 2018; Vlagopoulos, 2019). This has excluded and marginalized significant groups of individuals from obtaining care for eating disorders, resulting in major gaps in research with regards to how eating disorders show up among the various intersectionalities of identities. Examining both the reasons and implications for the lack of identity demographics in eating disorder epistemology from a decolonial lens provides insight as to the gaps and limitations of the western biomedical model’s ability to address the inclusivity of identity demographics, and proposes research solutions.

One recent study provides context for how identity demographics are being largely missed from eating disorder research. Findings report, “[A]s worldwide immigration has reached historical highs with movement patterns from Asian, African, or Latin American countries to Western ones, the question has been raised as to the effects of immigration on women’s body image and risks for eating disorders” (Sussman & Truong, 2011). The study’s findings indicate, “The effects are complex with home culture, level of acculturation, and other demographic variables affecting clinical dissatisfaction with one’s body and disordered eating”. However, also noting that “Methodological problems plague this research area and the inconsistent use of scales and other assessments impede rigorous comparisons or the ability to integrate the literature” (Sussman & Truong, 2011). Indigenous methodologies offer a framework and solution through the embracing of “both the active sharing and the mindful withholding of food as political acts, and acknowledge that culinary culture is not simply a market commodity but also a politically-embedded process” (Grey & Newman, 2018). Applying this definition to eating disorder diagnosis and treatment paradigms allow the inclusivity of identity demographics as they are related to food politics.

The findings of another study also report data on immigration and eating disorder epidemiology. “Building on psychoanalytic thinking about extremism and racism, the paper concentrates on particular ways in which the rhetoric and underlying anxieties around immigration have strong links with anorexic ideation. It posits that interchange across boundaries is important for health in both the economy and the individual and that, while rational argument about immigration levels is possible, extreme views in the contemporary US, UK and Europe are fuelled largely by irrational elements which can best be understood using psychoanalytic ideas (Kegerreis, 2020). These studies exemplify the limitation of a settler-colonial epistemology’s capability to adequately pathologize the etiology and epidemiology of eating disorders. Settler-colonial epistemologies have an innately invested stake in enforcing and maintaining certain beliefs and social systems that become the very determinants of eating disorders, such as the exclusion and/or erasure of BIPOC communities and socially harmful immigration and national border laws. Access to adequate and culturally appropriate healthcare in BIPOC and underserved communities, a decolonial understanding of racial justice issues, and the inclusion of settler-colonial social-industrial complexes’ influence on eating disorder epistemology are a few ways that inclusivity of identity demographics must be included in eating disorder research.

These studies illustrate how and why global phenomena such as immigration are crucial factors shaping eating disorders, often ignored in mainstream research. becoming one of the main ways identity inclusivity goes unchecked in eating disorder etiology and epidemiology. These studies also exemplify the necessity that global food systems theory and global political science be brought to the forefront of eating disorder etiology and epidemiology. Finally, this research indicates how the current settler colonial mental health paradigms are not equipped to adequately implement, integrate, and analyze the data. Indigenous paradigms focusing on food sovereignty and decolonization have been historically solidified in practice - offering structured theories, concrete practices, and tested results that are capable of responding to the gaps and limitations (Gilpin & Hayes, 2020; Kuhnlein, 2020a).

The WJOLELP Tsarlip First Nation Garden Project is an example of Indigenous regenerative health across Turtle Island and beyond which supports individual conceptions of self-determination, family wellness, and cultural well-being as they are dependent upon the wellness of the Land/Waters. “Meaningful connection to Land and Waters is the foundation for personal, cultural, and community governance, as well as regenerative health and wellness” (Gilpin & Hayes, 2020). Firstly, methodologies like this garden project in the utilization of eating disorder epistemology address food systems on a global scale through a holistic systems approach. Secondly, this methodology is an example of Indigenous food sovereignty as it addresses the bio-psycho-social effects of settler colonialism’s influence on food systems through the destruction of water habitats by mega-dams, deforestation, and the agro-industrial complex. Finally, it offers a response to the gap and limitation of western biomedicine’s exclusivity of identity demographics by its inherent definition of human beings as inextricably made up of related ecological systems throughout time and space.

The diagnosis and treatment of eating disorders must include traditional Indigenous epistemologies of identity, as well as, current colonial scientific understandings of the nature of human identity that are in alignment with Indigenous epistemologies. For example, research offered by the field of microbiology argues that human beings cannot be defined outside of symbiogenesis - “The result of the permanent coexistence of various bionts to form the holobiont (namely, the host and its microbiota)” (Guerrero, Margulis, & Berlanga, 2013).

Indigenous food sovereignty methodologies such as the WJOLELP Tsarlip First Nation Garden Project could offer research opportunities into the correlations of microbiota and the etiology and epidemiology of eating disorders within various communities of peoples, on a global scale, from an evolutionary standpoint, both before and after, settler colonialism’s influence.

Global Socio-economic Toll of Eating Disorders

Another critical gap and limitation of the western biomedical model of psychiatry and psychology regarding eating disorder etiology and epidemiology is the socio-economic toll accrued under this diagnostic and treatment paradigm. While there is a very limited scope of direct research on this topic, a few studies have been conducted revealing the cost effects for families, practitioners, and local and global societies. The several following studies outline how eating disorders are currently managed within health care, and some proposed adjustments to eating disorder research to correct the negative economic impacts are offered.

One of the few studies using national representational data investigated the prevalence and economic burden of eating disorders in South Korea. “The results showed that eating disorders are insufficiently managed in the medical insurance system. Further research is warranted to better understand the economic burdens of each eating disorder” (Lee, Hong, Park, Kang, & Oh, 2020). Another study conducted by the National Health Service for patients with eating disorders in Wales found the following:

“Eating disorders result in high costs to the NHS, particularly for hospital admissions. Therefore, greater investment in prompt recognition and early intervention for individuals with eating disorders, which greatly shortens the duration of illness, is likely to be economically justifiable.” (Tan, Humphreys, & Demmler, 2019).

A third study found: “Treatment and prevention of ED may have broader economic benefits in terms of health care savings and gains in work productivity than previously recognized. This exploratory study justifies large scale evaluations of the societal economic impact of eating disorders and comorbidities” (Samnaliev, Noh, Sonneville, & Austin, 2015). Other studies focusing on the economic impacts of eating disorders for individual patients, patient households, and caretakers have found further data. One study that is the first to empirically and quantitatively examine the household economic burden of eating disorders from the patient perspective offers the following,

“Results indicate that households experience a substantial burden associated with the

treatment and management of an eating disorder. This burden may contribute to maintaining the illness for those who experience cost-related non-adherence and by negatively influencing health outcomes. Current initiatives to implement sustainable and integrated models of care for eating disorders should strive to minimize the economic impact of treatment on families” (Gatt et al., 2014).

Despite differences in the economic impacts of eating disorders cross-nationally, there are several global trends exemplified from these studies. Firstly, there is the recognition that the economic burden of eating disorders is arising from inefficiencies within social systems’ such as health care management. While this literature inadvertently recognizes the socio-economic burden enacted by social systems as a determinant of eating disorder etiology and epidemiology, there is no further discussion offered as to why or how. Secondly, there is a call for the economic burden to be addressed in eating disorder treatment and recovery paradigms, however, there are no specific suggestions as to how the economic burden should be addressed.

A decolonial analysis offers insight as to how settler-colonial social industrial complexes, such as the medical-industrial health care system, are stakeholders in maintaining and perpetuating eating disorders, and therefore, are innately unequipped to adequately serve as a paradigm for true eating disorder diagnosis and recovery (Abramson & Starfield, 2005; Akabayashi, Slingsby, & Takimoto, 2005; Field & Lo, 2009; Gross, 2001; (Kassirer, 2001). For example, research finds that consumer adoption of the colonial disease model under the biomedical model of health care and psychiatry can create obstacles to treatment when hope is fundamental, stemming from a methodological financial conflict of interest of institutional stakeholders (Fava, 2007).

Furthermore, the loss of client-agency into the psychopharmaceutical-industry leads vulnerable consumers to lose identities in a manner equivalent to cult indoctrination, resulting in direct systemic opposition to true eating disorder recovery for clients (Murray Jr, 2009).

Analysis from philosophy, medicine, science, and law finds that “Research has become a for-profit industry, and the resulting financial conflicts of interest jeopardize human subjects, patients, and the future role of academic medical institutions. It is time to reconsider the clinical research system” (Gross, 2001).

Decolonial researchers lay out a more integrated approach to the discussion of eating disorders by utilizing broader inclusivity of diagnostic considerations such as obesity, by illustrating the embodiment of neoliberalism within the economy, culture, and the politics of fat (Guthman & DuPuis, 2006). Researchers “apply it by showing how today's twin phenomena of the discursive war on obesity and the so-called epidemic itself are better understood through the historical lens of neoliberalism, both as a political–cultural economic project and as a form of governmentality” (Guthman & DuPuis, 2006). This literature illustrates how neoliberalism is an embodied product of social-industrial complexes. It also serves as a backdrop for the explanation of how social-industrial complexes formed by insurance companies, mainstream colonial eating disorder treatment centers, and psychopharmaceutical companies become key stakeholders in perpetuating colonial determinants of eating disorders, ultimately reaping profit from eating disorder recovery patients.

Understanding how eating disorders are managed under the medical-industrial complex through decolonial epistemologies can provide the research needed to fill these gaps and limitations in research and understanding. Furthermore, Indigenous food sovereignty methods can provide context and practice for early intervention techniques that will lead to economic sustainability and prosperity. Not only will this provide economic appeasement for local and global health care, but it will also provide economic solutions for individual households and caretakers influenced by the economic impacts of eating disorders. Indigenous food sovereignty inherently places the key stakeholders of eating disorder etiology and epidemiology into the hands of food producers, individuals consumers, and health care patients ultimately alleviating the financial conflict of interest inherent in the social-industrial complexes that are predominant determinants of eating disorders.

Despite the severe socioeconomic and community health damages imparted by the Manitoba provincial government by way of an enforced hydroelectric dam called the Churchill River Diversion (CRD), the O-Pipon-Na-Piwin Cree Nation’s Indigenous food sovereignty movement is an example of how Indigenous food sovereignty restored environmental, cultural and economic prosperity to generations of a community ravaged by settler colonialism’s influence. The O-Pipon-Na-Piwin Cree Nation’s example of food sovereignty brings a framework that is globally adaptable and incorporates sustainable economic development paired with Indigenous self-governance (Akram-Lodhi, 2013). When applied to eating disorder epistemologies, Indigenous methodologies such as the O-Pipon-Na-Piwin Cree Nation’s food sovereignty efforts offer the socio-economic solutions needed to fill the above-mentioned gaps and limitations.

Efficacy of Client Recovery and Practitioner Satisfaction

A third major gap and limitation of the western biomedical model of psychiatry and psychology regarding eating disorder etiology and epidemiology is the efficacy of diagnosis and treatment models for client recovery rates and practitioner satisfaction. The inefficacy of treatment for eating disorders is, in part, a byproduct of the previous gaps and limitations mentioned above. The following studies outline other factors influencing eating disorder diagnosis and treatment efficacy such as a non consensus among eating disorder research funding and a lack of public health involvement in eating disorder research. Advisory measures for policymakers by eating disorder recoverers are discussed.

Firstly, there is underrepresentation for successful applications of medical eating disorder research funding, partly due to non-consensus among clinicians, researchers, consumers, carers, and interested members of affiliated industries, on the priorities for eating disorders research (Hart & Wade, 2020). One study, using the Delphi expert consensus method “resulted in a collaborative consensus-driven eating disorders research agenda for the Australian context and forms a model upon which other countries may also develop their funding priorities” (Hart & Wade, 2020a). The consensus results found that research domains of accessible evidence-based treatments, early intervention and detection, and origins of eating disorders as the most highly ranked (Hart & Wade, 2020a). Indigenous food sovereignty frameworks offer responses to these results through epistemology and methodologies that are inherently preventive, provide context for the origins of eating disorders, and offer evidence-based practices (Grey & Patel, 2015).

Secondly, a lack of public health perspectives that provide more nuanced eating disorder research data from a global context has been brought to the attention of clinicians for over a decade (Austin, 2012). Clinicians who have been advocating for preventative measures of eating disorder research report, “A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders. (Austin, 2012). Indigenous food sovereignty epistemologies incorporate a vast breadth of perspectives that shape the understanding of public health necessary in addressing these concerns. Food producers, food consumers, traditional ecological and environmental knowledge, medicine, technology, community relations, and sustainable and holistic socio-cultural systems approaches are all incorporated into Indigenous food sovereignty epistemologies (Kuhnlein, 2020b). Utilizing these perspectives in eating disorder etiology and epidemiology provides the framework and methodology required to address the lack of public health perspectives.

Implications and Future Research Aims

Researchers identified areas of improvement for policymakers by reporting from the key stakeholders- eating disorder recoverers. These areas of improvement included “media, healthcare practice and access, health insurance reform, education, objectification of the female body, and mental health stigma (Saunders, Eaton, & Frazier, 2019). Applied methodologies of Indigenous food sovereignty necessitates policy reform on each of these levels.

Native American film and video activism is an example of how Indigenous media emphasizes resistance, resurgence, and sovereignty in response to settler colonialism’s influence and impacts. “It is hence key to highlight that the critical arguments and examples provided [by Native American film and video activism] can support teachers’ work related to social justice. Teachers can use the examples and points made here as a reflection trigger with students in higher education across disciplines and high school, within and beyond the fields that tackle media, culture, sociology, and history” (Sonza, 2018).

An applied decolonial methodology of Indigenous food sovereignty also provides the public health perspectives needed to address eating disorder etiology and epidemiology on not only a macro scale, but through a holistic systems framework, and addresses eating disorder etiology and epidemiology as an interrelated symbiotic occurrence between organism and ecosystem (Kuhnlein, 2020). The gut microbiota and lifestyle have become focal points for eating disorder research (Lam, Maguire, Palacios, & Caterson, 2017; Mendez-Figueroa et al., 2019; Seitz, Trinh, & Herpertz-Dahlmann, 2019). For example, altered microbial diversity and taxa abundance were found and associated with depressive, anxious, and eating disorder symptoms. Microbiota-modulating strategies like nutritional interventions or psychobiotics application could become relevant additions to AN treatment” (Seitz et al., 2019). There are a plethora of Indigenous food sovereignty case study opportunities that could provide research and insight into the aforementioned correlations, as Indigenous food sovereignty applications occur in response to altered microbial diversity by the destruction of traditional food sources and nutritional deprivation in response to impacts of settler colonialism.

Systemic barriers within the healthcare system are well documented for those seeking

recovery from eating disorders, and in particular, for some specific native communities such as the Māori(Hewitt, 2012; Lacey et al., 2020) (Hewitt, 2012; Lacey et al., 2020). Indigenous food

sovereignty methodologies orient eating disorder recoveries as the key stakeholders in policy reform, not only addressing the concerns mentioned in the above study but incorporating policy reform that directly influences Indigenous communities’ sovereignty and wellbeing (Grey & Newman, 2018; Kuhnlein, 2020). Furthermore, studies on the positive effects of natural, alternative health care for eating disorders such as ayahuasca and psilocybin show promise for future treatment options, which traditional Indigenous knowledge holders and epistemologies could be at the forefront of (Hanes, 1996; Lafrance et al., 2017).

The ‘Prison Garden as Artistic Boundary Object’ is an example of Indigenous methodologies “fostering food sovereignty and social citizenship for Indigenous people in British Columbia” (Timler & Brown, 2019). Timler, Kelsey, Brown, and Helen expand upon the intrapersonal and intergenerational connections required for the acquisition of food security and nutrition encompassing the social, cultural, and economic practices surrounding the production and consumption of food in Indigenous communities’ foodways and practices (2019). “However, colonialism, state-sponsored structures of violence, socioeconomic marginalization, and dispossession have purposefully disrupted these Indigenous foodways in British Columbia, resulting in food insecurity as well as the wider negative impacts of reduced food sovereignty - social isolation, spiritual disruption, economic vulnerability, low educational attainment, and high unemployment” (Brown, H. & Timler, 2019). The ‘prison garden as artistic boundary project’ is an example of how Indigenous food sovereignty restores notions of citizenship and place holdings in communities where individuals are ravaged by food insecurity in response to the impacts of settler colonialism.

Sexual assault is another well-documented example of how food insecurity leads to

abuse, and in response, the adoption of eating disorders as a survivalist coping mechanism cross-culturally (Laws & Golding, 1996). However, the disproportional rate of missing and

murdered Indigenous women is a prime example of how food insecurity leads to disproportionate detrimental social impacts such as sex trafficking for Indigenous communities. When the potential of formal education systems in preventative education for Indigenous girls vulnerable to the sex trade was investigated, it was found that poverty was a main determinant for the elicitation of Indigenous girls into the sex trade, and meeting basic needs was one of the main instances for recruitment ((Louie, 2016). Preventative education including Indigenous food sovereignty methods, such as how to restore the production of one’s foodways, addresses one of the main determinants of eating disorders and sex trafficking - food insecurity.

Some weaknesses of the Indigenous food sovereignty movement have been put forth including a missing network of documentation regarding who is producing what foodstuffs; the many challenges of the high cost associated with distribution and functionality of respective food systems; the historical trauma and breakdown of natural laws that have weakened the state of communal connection within and between native communities; and the accepted colonization of governmental policies within tribal government leading to an acceptance of the transnational corporate food system model (mono-culture, nitrate-based fertilizers, pesticide and herbicide use, genetically modified organisms, terminator seeds, and preservatives) despite the clear medical statistics evidencing its destructiveness for Indigenous and all peoples’ well being and very survival (Balbas, n.d.; Whyte, 2016).

However, there are also proposed opportunities documented addressing how to confront these weaknesses such as strengthening the small and emerging traditional food systems already functioning through trade and exchange; soliciting the support of institutions; soliciting the Native Food Sovereignty Alliance as an advisory council to advice policy-makers, local communities wanting to begin a resurgence of traditional food systems through youth groups, gardening projects, ect; forming solidarity with other social institutions; training gardeners

regionally, according to local food traditions, climates, water availability, local legal and political climate, ect; and through growing a “Farms to School” movement (Balbas,). Utilizing Indigenous food sovereignty methodologies and practices in response to eating disorder etiology and epidemiology provides the application of those opportunities through means which I hope I have adequately laid out within this paper.

In the face of increasing threats of public health crises, economic and environmental collapse, this offering contributes to the discourse on the prevention of, and restoration from, the global health and mental health crises, cultural restitution for communities affected by settler colonialism, climate solutions, socio-political and economic reform, and public health and safety. Indigenous food sovereignty is a viable, practical solution to filling the gaps and limitations of the western biomedical model’s diagnosis and treatment paradigm for eating disorders. Not only would applying the decolonial methodology of Indigenous food sovereignty to eating disorder etiology and epidemiology provide crucial responses to critical issues Indigenous communities face such as food insecurity and sex trafficking, cultural degradation, and health crises - it has the potential to impact all communities affected by the detrimental impacts of settler colonialism’s influence on land, bodies, sexuality, and food systems. Indigenous food sovereignty is a decolonial methodology and framework that responds to the issues raised by extensive eating disorder review literature and offers opportunities for beneficiaries across

socio-political-economic lines worldwide.


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