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Marginalization Multiplied

Marginalization Multiplied

By Kathryn Cortese, LCSW, ACSW, CEDSKathy Cortese-2x2.647

As therapists, we learn so much from our clients. When individuals are diagnosed with an eating disorder and are members of a marginalized community, I have learned these persons live lives of “marginalization multiplied.”

According to Miriam-Webster, the simple definition of marginalize is “to put or keep (someone) in a powerless or unimportant position within a society or group.”

NEDA in partnership with Reasons Eating Disorders Center has taken on the compelling work of their Marginalized Voices Campaign. The goal of this effort is to challenge “the prevailing myths about who struggles with eating disorders, underscoring that everyone’s experience is equally as valid and deserving of care and recovery.” (To learn more, please go to

With much gratitude to Lori Price for her commitment to the eating disorders community and her powerful words in the previous article that describe her experience as a marginalized voice, I follow with thoughts on another layer of marginalization with which people with eating disorders co-exist, based on some practice wisdom.

A number of years ago, when sitting with some of my ED clients, I realized that one impact of their eating disorder is what I call “living in the margin.” I would ask my clients to picture a regular sheet of loose-leaf paper. We likened the day-to-day, internal and external processes of living life with an eating disorder as existing in the margin of the loose-leaf. We would use this metaphor to imagine a different life and what it would mean to take up the full page – to be free to find and actualize their true selves. Always, a scary thought, yet, oftentimes quite motivating. No one ever denied living “in the margin.” Some found the safety of the ED margin to be a comfort, yet they also knew their authentic self was being squeezed out of the picture by the compulsions, the rules, the demands, and the commands of the ED. Some felt their voices were powerless against the ED voice and its spewed messages of hate, disparagement, and malicious criticism. Some viewed their position in their world of family, school, and friends as meaningless, insignificant, and worthless. In other words, they lived in “the margin.” Developing the courage to use one’s skills and voice in recovery takes savvy, courage, moxie, grit, persistence, strength to face adversity and setbacks, and determination to be on an equal footing with the rest of humanity – pretty similar to the members of our ED community who also experience marginalization.

These clients’ ability to articulate the potential differences between lives “in the margin” vs. “on the full page” led to some lively discussions about hope, recovery, and their future. Sometimes, this image led to an assignment. I would suggest they simply draw or fill the full space on their loose-leaf paper with colors, abstractions, or collage cutouts for follow-up conversations.

We all “get this.” To complement the work of The Marginalized Voices Campaign, have we taken the time necessary to “see” if we might play a part in marginalizing any of our members of the ED community? How do we challenge the “ideals” culture promotes? Did the previous article by Lori Price strike a chord? Can we all open our minds and hearts and those around us to “get it?” Lori’s is one voice. We know there are many more. Each is valuable and deserves opportunities and access to recovery.

We are all in life on this planet together and, hence, in the pursuit and establishment of equality for every individual. We welcome your comments to this article to offer suggestions for advocacy, education, research, prevention, treatment, the experience of visibility devoid of judgment, and more, so that “marginalization multiplied” is reduced and perhaps extinguished.

About the author –

Kathy Cortese, LCSW, ACSW, CEDS, has worked as a clinician in the eating disorders field since 1989, and now also serves as president and editor-in-chief of the Gürze/Salucore Eating Disorders Resource Catalogue.

Kathryn Cortese, LCSW, ACSW, CEDS, began working with individuals with eating disorders in 1989. She is committed to the beliefs that recovery is real, support is essential, and hope matters. In 2013, along with her son, Michael, Kathy purchased the Gürze Catalogue. They offer the annual Gürze/Salucore Eating Disorders Resource Catalogue, a monthly ENewsletter featuring articles specifically written for this as well as a Book Interview, the website,, the ED Pulse, and in the fall will launch their  podcast, called ED Matters.




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