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Experts are calling for stronger investment in the treatment and prevention of eating disorders among Māori.
Otago University’s Faculty of Medicine has released new research highlighting the need to embed Māori expertise and whānau-centred approaches into national policy and treatment pathways.
Lead researcher Mau te Rangimarie Clark (Tainui/Ngāti Pikiao/Ngāti Kahungungu) of Otago’s Department of Psychological Medicine said Māori experience eating disorders at rates comparable to, and in some cases higher than, non-Māori.
“Māori are equal to that of non-Māori for disorders like anorexia, but if we look at disorders like bulimia, it’s almost double.”
Clark said despite the prevalence of eating disorders among Māori, far too often, stereotypical social narratives block their access to diagnoses and treatment.
“Eating disorders are seen as a ‘privileged’ problem and tend to be associated with European women, while Māori presenting with concerns or symptoms tend to be overlooked.”
Otago University partnered with Christchurch Kaupapa Māori mental health provider Purapura Whetu to host wānanga with frontline kaimahi who use Ngā Maiuri Kai - a Māori framework for understanding eating disorders.
The study highlights how food insecurity, poverty and trauma are deeply intertwined with disordered eating experiences for many whānau.
Kaimahi described patterns of “DPB eating”, where periods of food scarcity followed by access to money or food could trigger binge-eating behaviours, particularly for parents trying to prioritise feeding children ahead of themselves.
It said current mainstream approaches often failed Māori by focusing too heavily on weight-loss interventions while overlooking trauma, emotional wellbeing and wider social determinants of health.
Participants also described concern about people being directed toward dieting, bariatric surgery or weight-loss medications without adequate psychological support.
“Government recognition of Kaupapa Māori services within the New Zealand Eating Issues and Eating Disorders Strategy has been an important first step, but our findings show these services and their expertise remain significantly underused.
“Achieving equity for Māori experiencing eating disorders will depend on whether Kaupapa Māori knowledge is genuinely embedded in commissioning, workforce development and treatment pathways across the health system,” Clark said.
Clark said participants repeatedly stressed the importance of whakawhanaungatanga (relationship-building) in supporting recovery.
“Kaupapa Māori services work from a whānau ora model, where tāngata whaiora (people seeking wellness) are seen as experts in their own lives and healing journeys,” he said.
The study also found Māori with eating disorders were frequently excluded from specialist services because of strict eligibility criteria, especially when they presented with complex mental health conditions, substance use, autism or trauma histories.
“Kaimahi talked about Māori being bounced between fragmented services that treat problems in isolation rather than recognising the interconnected realities of people’s lives,” he said.
Researchers are calling for longer consultation times, better integrated care, culturally safe workforce training, expanded peer-support programmes and the development of Māori-centred assessment and screening tools that better reflect Māori experiences of wellbeing.
Co-author Associate Professor Jenny Jordan said the findings reinforced the value of kaupapa Māori approaches already operating within communities.
“This study moves beyond describing the problem to identifying practical solutions. It shows how Kaupapa Māori providers are already delivering strengths-based, culturally grounded responses that align closely with the government’s own strategy priorities,” she said
The paper builds on an earlier hypothesis paper, also led by Clark, exploring how rongoā Māori (traditional holistic healing) could potentially be integrated alongside Western psychotherapy approaches to support Māori experiencing eating disorders.
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