TĀNGATA WHAIORA AS NGĀ KAIWHAKATERE – UNDERSTANDING THE EXPERIENCES AND NEEDS OF MĀORI WITH NGĀ MĀUIUI KAI (EATING DISORDERS)

<p><strong>Eating disorder research has long been dominated by Western, Educated, Industrialised, Rich and Democratic populations. The same pattern is reflected in Aotearoa (New Zealand), as there is a paucity of research that has sought to understand eating disorders among Māori, the tangata whenua (Indigenous people of the land). Despite this, it is recognised that eating disorders can affect anyone, regardless of ethnicity, culture or economic position. To contribute to this small but growing body of knowledge, my thesis explored the experiences and needs of Māori with eating disorders using Kaupapa Māori methodology and qualitative research methods, including interviews and Reflexive Thematic Analysis. Three interconnected studies underpinned this thesis. Study One involved interviews with seven kaumātua (elderly) and pakeke (adult) to explore what a culturally appropriate understanding of eating disorders looks like for Māori. The thematic analysis comprised four themes – Kai like Korowai, Navigating Two Worlds, Te Pō, and Tikanga-Informed Care in a Pākehā System. This study highlighted the shortcomings of Western and Eurocentric conceptualisations of eating disorders in understanding Māori experiences, which overlook Māori experiences of navigating ideals relating to beauty and body image. It also demonstrated that Western perspectives do not capture the multifaceted view of kai and the holistic understanding of wellbeing held within Te Ao Māori (the Māori world). Informed by insights from Study One, Study Two involved interviews with 12 tāngata whaiora (people in search of wellbeing) with lived eating disorder experience. Four themes were constructed – Control Among the Chaos, Separation From Our Rongoā, “But Māori Don’t Get Eating Disorders”, and Whāia Te Ao Mārama. This analysis illuminated the diverse ways tāngata whaiora experience eating disorders. It also demonstrated the unique challenges and experiences faced by tāngata whaiora, such as overcoming social barriers and navigating tikanga (correct procedure, the customary system of values and practices that have developed over time and are deeply embedded in the social context) with an eating disorder. These challenges often went unaddressed due to the dominance of Western and Eurocentric knowledge and research for understanding, assessing and treating these disorders. Study Three extended the focus to those who practise and research in the field of eating disorders, and involved interviews with five kaimahi (workers) and kairangahau (researchers) Māori. This thematic analysis also comprised four themes – Traversing Insidious Racism, ‘If Not Me, Then Who?’, A System Where I’m an Outlier and Tūngia te uruuru kia tupu whakaritorito to tupu o te harakeke. Study Three showed that kaimahi and kairangahau Māori also faced unique challenges and experiences, including additional responsibilities and navigating power imbalances, highlighting the need for dedicated Māori eating disorder services. Woven together, these three studies illustrated the different ways that Māori understand and experience eating disorders. They also highlighted how tāngata whaiora face numerous barriers to receiving support, and how their experiences are often rendered invisible in research, practice, and broadly, how we understand eating disorders. Despite this, many tāngata whaiora in this research spoke about how they overcame these obstacles, and their pūrākau (story) served as a demonstration of their resilience and strength.</strong></p><p>The central discussions of my thesis offered several implications and recommendations. These included equity-focused solutions such as developing priority pathways for Māori with eating disorders, investing in resources to improve eating disorder awareness and understanding, and expanding eating disorder curricula in healthcare training programmes. I also suggested possible avenues for prevention and treatment that are embedded within Te Ao Māori. Importantly, I argued that participants’ pūrākau destigmatises individual and collective understandings of eating disorders. Overall, this thesis represented a shift away from the marginalisation of Māori experiences with eating disorders and provided a foundation for further approaches to eating disorders that are culturally grounded.</p>