A Foucauldian Discourse Analysis of 'Eating Difficulties' in Other Specified and Unspecified Feeding and Eating Disorders (OSFED/UFED)

The medical model appears to dominate the understanding of 'eating difficulties' in current literature and practice. This study set out to critique this pathologising lens by reviewing the concept of 'eating difficulties' in individuals who identify with symptoms of the diagnostic label of OSFED/UFED. The purpose was to understand how various ways of talking about 'eating difficulties' impact subjectivity and practice. The focus of this study was on the discourses mobilised in the context of this diagnostic label to better represent and understand this eating disorder diagnostic category in a humanistic way.

Six individuals self-identifying with OSFED/UFED were interviewed using a semi-structured interview. This was analysed using a Foucauldian Discourse Analysis (FDA) from a social constructionist position. The analysis identified five main discursive constructions set within a wider discourse: (1) Eating difficulties as a binary or rigid concept (2) Eating difficulties intertwined with fatphobia (3) Eating difficulties in relation to the OSFED diagnostic label (4) Eating difficulties as transdiagnostic (5) Eating difficulties as a spectrum. Given the prevalence of the medical model, the first four discursive constructions draw from the dominant biomedical discourse. At the same time, the 'spectrum approach' emerged as a counter-discourse resisting the privileged dominant understanding of eating difficulties. Overall, the construction of 'eating difficulties' through a biomedical discourse is argued to uphold problematic power structures and undermine the experiences of individuals who do not fit into rigid diagnostic labels and fall under the subthreshold OSFED/UFED label.