"We Only Treat People with a BMI of 15 or 16" Recovered Voices on the Human Cost of Arbitrary Thresholds and What Truly Matters in Eating Disorder Recovery

Abstract

This thesis sought to understand what truly helped people recover from an eating disorder in the Netherlands, based on the voices of those who had lived through it and come out the other side. The title, "We Only Treat People with a BMI of 15 or 16", came directly from one participant's experience and pointed to a central problem that the study would explore: how arbitrary thresholds can shape suffering and delay recovery. Through semi-structured interviews with eight recovered individuals and a qualitative analysis grounded in identity theory (Burke and Reitzes, 1981; Burke and Stets, 1999), this study aimed to uncover what really mattered in recovery according to those who had navigated it. The findings revealed several key themes that together painted a complex picture of what helped, what harmed, and what remained missing in Dutch eating disorder care. What patients needed most, this thesis argued, was not more rigid protocols but something more fundamental. When lived experience was centred, care became humanised and effective. These recovered voices offered not just critique but a practical guide for strengthening social work practice and redesigning eating disorder care around what truly helped.