The system won’t save us: Reflections from Korea’s EDAW 2025

The system won’t save us: Reflections from Korea’s EDAW 2025

Korea’s Eating Disorder Awareness Week (EDAW) 2025 was a whirlwind. I lived like a ghost, confined to my room packed with boxed props. My resignation letter had been submitted to my full-time job. My focus was stretched thin across every detail of the daily sessions: ticketing, Instagram promotions, Google Meet access for international panelists, Korean subtitles for pre-recorded presentations, live translation, and YouTube live streaming.

By the end of those seven intense days, I was left with a pile of yellow post-its, filled with audience questions for each panelist. My next task? Sorting them, translating them, and sending them to the international speakers.

Unfortunately, I suffered from severe nausea throughout the week. I couldn’t eat properly, surviving on cups of hot barley tea and fruit. This experience led me to a rather scientific question: How does a changed physical state affect appetite?

I couldn’t enjoy the foods I crave or indulge in the things I would normally want to devour instantly—a phenomenon reminiscent of those suffering from COVID-19-related taste and appetite loss. I wouldn’t know firsthand, though—I seem to have super immunity, having never caught COVID-19.

This, in turn, led me to another intriguing question: Why do some people with anorexia seem to have enhanced immunity—like me? It’s a topic I’ve noticed but rarely see explored scientifically.

The healthcare system’s failure

Korea’s National Health Insurance system operates on a fee-for-service payment model rather than the global budgeting system used in many European countries and Australia. This structure primarily benefits medical doctors and psychiatrists while excluding other essential professionals such as nurses, psychologists, and dietitians. Non-doctor services are not covered at all under the system.

Some argue that the only way to establish a proper eating disorder treatment system in Korea is to raise the insurance fee for psychiatrists’ eating disorder treatments, essentially incentivising them to enter the field. But while this might attract more psychiatrists, it won’t be the ultimate solution.

The case of CBT-I (Cognitive Behavioural Therapy for Insomnia) is a notorious example of how Korea’s fee-for-service payment system has failed.

As in most other countries, clinical psychologists in Korea initially provided CBT-I sessions to their patients. However, in 2018, the government introduced an official insurance fee for these sessions—sparking strong opposition from clinical psychologists.

Why did the clinical psychologists object?

The National Health Insurance fee applies only to psychiatrists’ practices. Therefore patients seeking CBT-I from psychiatrists pay significantly less, while psychologists—who are not covered—become the more expensive and less accessible option. As a result, patients naturally avoid psychologists, leading to declining demand for their services.

But the absolute failure came next: Psychiatrists found the newly set insurance fee too low and ultimately lost interest in offering CBT-I at all. Only a handful continued practicing it.

The outcome? A complete deterioration of Korea’s insomnia treatment system.

You can visit any nearby private psychiatrist for general psychiatric concerns—such as depression, anxiety, daily life difficulties, or children’s school maladjustment—and pay only ₩10,000 to ₩20,000 per session. However, if it’s your first visit, additional psychological assessments are required, which are handled by psychologists and cost about 10 times more than a regular psychiatric session.

No coverage for eating disorders

Regarding eating disorders, the National Health Insurance system provides no coverage. General psychiatrists lack the knowledge to treat these “difficult” patients, making private psychiatric clinics entirely inaccessible for those with eating disorders.

Yes, there are specialised eating disorder clinics, but fewer than five exist in the entire country, all concentrated in and around Seoul. And to visit one, you must pay over ₩100,000 (about AUD $109) just for a psychiatric consultation, plus a similar amount for a psychologist’s “actual” counselling session—all completely out of pocket.

The private psychiatrist-run inpatient program for eating disorders, where my family once paid ₩4,000,000 (about AUD $4371) for a two-month stay in 2002, no longer exists—shut down long ago due to chronic financial deficits among other reasons. (As you might suspect, there’s more to this story than I’m sharing here.)

Currently, there are no specialised inpatient programs for eating disorders anywhere in the country. Even major university hospitals refuse to establish such programs because they are not financially viable.

Recently, a foreign diplomat contacted me via LinkedIn, asking for recommendations on inpatient treatment options for his daughter. What could I possibly tell him?

At the Health Policy Session of EDAW 2025, Prof. Changyeop Kim—a respected senior health policy scholar and founder of the NPO People’s Health Institute—emphasised an important point:

Despite everything—including the prolonged doctors’ strike and reports of medical school students being pressured to take leaves of absence immediately after enrolment by their seniors—we should not blame individuals but instead focus on the systemic issues at play.

I fully agree with Prof. Kim. But the real tragedy is that I face classism and medical feudalism embedded in their thinking and actions every single day. And this constantly obstructs my efforts to collaborate with them.

Rethinking support for eating disorder sufferers

Korea’s EDAW has always been free of psychiatrists—perhaps because it is a patient-led event, dismissed as unimportant, unscientific, or overly emotional.

The first generation of eating disorder specialists in Korea flatly refused my invitation to participate from the very beginning. And now, I have abandoned my strategic connection with another eating disorder specialist—the same person who initially suggested that I organise Korea’s EDAW in the first place. (For now, I can’t reveal the  story behind that decision.)

On the other hand, I believe the right path for me and all of us is to move in a different, alternative direction, rather than relying on the existing medical system.

I say this because I wonder if eating disorders are truly something that can be “healed” by psychiatrists. Perhaps what sufferers need is not a psychiatric intervention, but a different kind of relationship, a different kind of community, or even a different kind of society.

I’m reflecting on this now, and one of my greatest inspirations is the peer support communities for eating disorders in Japan, particularly Ohana—a space where not only sufferers but also their families, researchers, and even clinicians come together as equal members.

Would it be possible to create a community where people with lived experience of eating disorders design curricula and lecture for researchers and psychotherapists? Or a community built around knitting, sharing meals, and simply being together?

I keep thinking.

The clues are within us

I’ve never considered myself an activist, but now I have a lifelong question that resonates deeply with the world’s contemporary dilemmas.

Globally, we are in an eerily similar situation, and Korea is no exception.

I believe that the mystery of eating disorders—a condition entangled with systemic issues surrounding women (and men), food, the act of eating (or not eating), and the human body itself—holds a crucial clue that could help us better understand and address these broader societal struggles.

That’s why I cannot ignore this permanently neglected issue.

My life goal is to take different, unexpected actions—to create even the smallest crack in this dysfunctional society.

I want to prove that a so-called “patient”—a person with lived experience—can take action in radically different, unprecedented, and entirely non-compliant ways.

These are actions that psychiatrists cannot exploit for their pursuit of fame.

Above all, I am grateful that I have a lifetime’s worth of things to learn.

Watch the full sessions of Korea’s EDAW 2025

You can watch all seven sessions of Korea’s EDAW 2025 on the Rabbits in Submarines Collective YouTube channel:

The Researchers Session – February 24th
https://www.youtube.com/watch?v=V3YK9b3yIb4
The Revolution Session – February 25th, featuring Susannah Fox
Part I: https://www.youtube.com/watch?v=SROWGV1dw5I&t=1s
Part II: https://www.youtube.com/watch?v=1ljPTSGkQU0&t=3945s
The Australia Session – February 26th, featuring Gemma Sharp
https://www.youtube.com/watch?v=EKUMykmftKY&t=3719s
The Japan Session – February 27th, featuring Rie Yamada, Ako Miyashita, Cocoro Suzuki, and Chiaki Yazaki

The Health Policy Session – February 28th, featuring Changyeop Kim
https://www.youtube.com/watch?v=1pYyF4UJpoM&t=16s
The Italy Session – March 1st, featuring Riccardo Dalle Grave and Aurora Caporossi
https://www.youtube.com/watch?v=Oa6oRRaqYO0&t=4s
The Children/Adolescents Session – March 2nd, featuring Paula Kim, Victoria Ying, Yeoleum Cha, and Wanseok Kho
https://www.youtube.com/watch?v=t5gOTUnbeXY