Date of Award

Spring 2024

Degree Type

Capstone - Open Access

First Advisor

Jonathan P. Kessler


Eating disorders have one of the highest mortality rates of all mental illnesses (NEDA, 2021). The rate of relapse among patients who receive traditional eating disorder treatment is significant (Berends et al., 2016). The treatment landscape for eating disorders has historically been rooted in abstinence based models. According to Williams et al. (2010) this often overlooks and minimizes the complexity of individual experiences and continues to perpetuate stigma. Despite significant advancements in research and clinical interventions, current models frequently fall short in addressing the multifaceted nature of these complex disorders. However, evidenced based research and clinical practice shows the potential efficacy and ethical imperative of integrating harm reduction principles into treatment approaches (Janse van Rensburg, 2020). This paper critically examines the shortcomings of traditional treatment approaches, highlights their limitations in fostering sustainable recovery and mitigating harm. Through a comprehensive review of current literature, the prevailing emphasis on abstinence-based frameworks and its implications for patients' autonomy, stigma, and long-term outcomes are explored. A study done by Andersen et al. (2021) revealed that there are five main themes as to why people do not access traditional eating disorder treatment: (1) Disagreement on treatment needs, (2) rigid standard procedures, (3) failure to listen, (4) deprivation of identity, and (5) mistrust and fear. Moreover, the inherent flaws in the dichotomous view of success and failure within the context of eating disorder treatment, as researched by Leavy et al. (2011) underscores the importance of embracing a more nuanced understanding of progress. The conceptual framework of harm reduction within the context of eating disorders, emphasizes its compatibility with a patient-centered, holistic approach to care (Westmoreland & Mehler, 2016). Furthermore, there are potential benefits of harm reduction strategies which include promoting engagement, reducing shame, and enhancing long-term outcomes (Khan et al., 2022) . Through an analysis of current practices and emerging evidence, this paper advocates for a paradigm shift towards a harm reduction-oriented model of care in the treatment of eating disorders, ultimately prioritizing the well-being and autonomy of each individual on their recovery journey. The results of this systematic literature review demonstrates that there is a paucity of evidence related to the application of harm reduction interventions when they are applied to the treatment of eating disorders. Further research studies are needed on this subject in order to assess outcomes.