Collective responsibility and ecological thinking in eating disorders: moving beyond individualistic models of illness and recovery

Eating disorder treatment and recovery are often framed as matters of individual responsibility, with change positioned as dependent on the person’s motivation, insight, and willingness to recover. While agency remains important, this paper argues that such framings are too narrow and can obscure the wider conditions that shape both illness and the possibility of recovery. Drawing on ecological systems theory, ecosocial approaches to health, evolutionary psychiatry, and lived experience, this paper develops an account of eating disorders as phenomena that arise within interacting systems of biological vulnerability, interpersonal relationships, sociocultural pressures, institutional arrangements, and political economy. It argues that individualistic models of illness and recovery may contribute to shame, stigma, epistemic injustice, and what is described here as hyper-responsibilisation, particularly where care is fragmented, delayed, or unequally distributed. In contrast, an ecological perspective allows eating disorders to be understood as embodied and socially patterned forms of suffering that cannot be adequately addressed through individual behaviour change alone. The paper concludes that if eating disorders are ecological in their production and maintenance, then responsibility for responding to them must also be ecological. Recommendations are made to support more collective, relational, and structurally informed approaches to prevention, treatment, and recovery. Eating disorders are often talked about as if recovery mainly depends on the individual trying hard enough, wanting to get better, or being motivated to change. This paper argues that this is too simplistic. Eating disorders do not develop or continue only because of personal choices or psychology. They are shaped by a much wider set of influences, including biology, relationships, life experiences, social pressures, stigma, access to care, and the environments in which people live. Drawing on theory, research, and lived experience, the paper shows that recovery is also affected by whether people are recognised, believed, and supported in ways that fit their actual circumstances. When too much responsibility is placed on the individual, important parts of the picture can be missed and people may be blamed for struggles that are not fully within their control. The paper argues for a more collective approach, where responsibility for prevention, care, and recovery is shared more honestly across services, communities, and society.