Support for people with eating disorders such as binge-eating and anorexia nervosa must be better tailored to the experiences and needs of Māori, Bailey Rose says.

Bailey (Ngāti Maniapoto) has won a two-year $95,939 Health Research Council PhD scholarship to understand the experiences and needs of Māori with eating disorders.

She is two years into her doctorate and is also studying for a postgraduate diploma in clinical psychology in the University’s Te Kura Mātai Hinengaro—School of Psychology.

Bailey says eating disorder research has typically been dominated by Western populations. However, there is growing recognition that disorders such as anorexia nervosa, bulimia nervosa, and binge-eating affect people regardless of ethnicity, culture or economic standing.

To date, research has overlooked the Māori worldview, and failed to recognise other ways of knowing and experiencing disorders, she says.

“Māori have different views around food but also around the body. And Māori are more likely to face ongoing repercussions of colonisation, whether that means poor access to health care, systemic racism, or problems of access to kai, such as food insecurity.

“Some people believe that Māori have been more accepting of larger bodies and so might be somehow protected from eating disorders. That overlooks the fact that, as Māori, we are still situated within Western societies, being fed the same messages of how we should look, how and what we should eat.”

Bailey has three studies underway. In the first, just finished, she talked to half a dozen kaumātua about their perspectives on what it means to eat healthily, what it means to have a healthy body, and if behaviours such as restricting the intake of kai appear in traditional Māori stories.

Her second study involves talking to at least 10 Māori who have experienced eating disorder. For this study she is working alongside a Māori dietician and a Māori clinical psychologist.

“I often go to work and get tapped on my shoulder and hear, ‘hey, I’ve heard about the research you are doing. That's really important. I have such and such in my whānau, sisters, cousins, who’ve struggled with that’.”

For her third study, Bailey is talking to Māori healthcare professionals and researchers who are working in the field of eating disorders. She intends to explore their perceptions of barriers, such as what they think gets in the way of services meeting the needs of Māori, as well as providing recommendations for eating disorder services in Aotearoa.

“This will assist in improving services so they are tailored to the needs of Māori.”

Māori are currently not being assessed or being assessed inappropriately or incorrectly, she says.

“Anecdotally, I hear from other healthcare professionals that they have Māori coming through their services and often eating disorders are not assessed for or even considered. Then, when someone finally conducts a thorough assessment they find the client has got a full-blown eating disorder.

“It is critical that we are appropriately assessing for and treating eating disorders, as a failure to do so may exacerbate the disorder. This is especially important when we consider the health consequences such as impacts on dental and cardiovascular health, and the fact these disorders are highly comorbid with a number of mental disorders, like depression and anxiety.”

Bailey hopes to work as a clinical psychologist at a kaupapa Māori mental health service in the future. She also hopes to continue conducting Māori health research once she has completed her PhD.