Warning: This article contains references to eating disorders which may be distressing to some audiences.
The Ministry of Health reports a three per cent lifetime prevalence of eating disorders among Māori - but that figure is more than 20 years old.
The data gap means there is limited understanding of how eating disorders affect Māori, particularly wāhine Māori. Rebecca MacKenzie’s PhD research is helping fill that gap by exploring the experiences of wāhine Māori with eating disorders.
A researcher and lecturer at the University of Auckland, Rebecca (Te Aupōuri, Ngāti Porou) has research shaped by her own experience with anorexia.
“In my late 20s, I went through a very rough patch. It was quite a traumatic time for me and, as a result, I stopped eating and was subsequently diagnosed with anorexia,” she says.
“While I met the diagnostic criteria, I rejected that diagnosis. It didn’t explain the way I felt, it didn’t explain what had happened, and it didn’t fit within my wairua as something that I wanted to align with myself.”
The Ministry of Health describes eating disorders as conditions that affect how a person eats and thinks about kai, weight or their tinana. They include anorexia, bulimia and binge eating disorder, and can involve restricting kai, binge eating, purging or excessive exercise.
Ngā āputa raraunga
After her experience, Rebecca went on to complete her PhD, finding there was very little Māori-focused research into eating disorders.
The most comprehensive national data on eating disorders in Aotearoa comes from Te Rau Hinengaro, a national mental health survey carried out in 2003 and 2004. It found Māori had a higher lifetime prevalence than non-Māori, at three per cent compared with around two per cent.
“And yet that statistic is not reflected in any of our treatment,” Rebecca says.
The survey only measured anorexia nervosa and bulimia nervosa and did not include people under 16.
Te pūtake o ngā māuiui pongakawa
Rebecca received more than 200 applications for her rangahau before interviewing 12 wāhine Māori with eating-disorder diagnoses.
“One of the biggest findings was it wasn’t about food, and it wasn’t really about bodies,” she explains.
“It looked at their struggles with their identity. It looked at racism; it looked at intergenerational trauma.”
Rebecca says the wāhine spoke about:
- Identity: Some struggled to feel Māori enough or accepted in te ao Māori. For some, their eating disorder became tied to their sense of identity.
- Racism: Experiences of racism affected their sense of identity and belonging.
- Intergenerational trauma: Some spoke about trauma carried through generations and behaviours they saw reflected in their mothers and whānau.
- Whānau and food insecurity: Some grew up in whānau affected by food insecurity and were expected to clear their plates, even when they were full. For some, this later became linked to bingeing or purging.
- Colonisation: Rebecca says colonisation disrupted relationships with kai, whānau and identity, while imposing racialised ideas about bodies and beauty.
She says this shows how eating disorders can be missed when they are viewed only as individual psychological or body-image problems.
“It’s not a personal thing; it’s often a response to much broader, bigger structures that are impacting on our lives, and that needs to be understood.”
Rebecca highlights the importance of kai in Māori culture and says services need to better understand the role it plays in Māori lives.
“We need to have a targeted workforce that is able to speak to some of the ways in which we have relationships with kai and find that balance between it is positive and it is celebratory, and it can be harmful.”
Ngā rongoā
The Government’s 2025 strategy aims to improve eating-disorder support, from early help through to specialist and hospital care. Health New Zealand is putting an extra $4 million a year into services, bringing total annual funding to more than $23 million.
Rebecca says people should seek help as early as possible.
“Don’t wait until you think you’re sick enough to ask for help, because that goalpost will keep changing. It’ll become a goal that you are never able to reach,” she says.
“Tell someone you trust what is happening, and if you feel like you’re dismissed, keep advocating for yourself.”
National helplines:
Eating Disorder Association NZ: 0800 233 269 - support and information for whānau and carers supporting someone with an eating disorder.
1737: Call or text for free, confidential mental health support from a trained counsellor
If it’s an emergency and you or someone else is in danger, call 111 immediately.
