Who gets to decide? Matters arising from Robinson et al. (2024), "Can people with longstanding bulimia nervosa suffer from severe and enduring eating disorder? A qualitative study".

Written by a researcher with lived experience of long-standing bulimia nervosa, this Matters Arising piece commends Robinson et al. (2024)'s study for its focus on exploring the subjective experiences of patients who are often overlooked in clinical and academic discussions. However, several concerns can be raised about the epistemological, methodological, and ethical foundations of this research. These include the limited engagement of participants with the terminology used to describe their experiences, and the use of language which remains contested. The author highlights how this approach risks imposing external narratives on participants, arguing instead for more equitable co-production methodologies which include participants as epistemic agents in their own right. Recommendations for future research include the equitable inclusion of people with lived experience, recognising the limits of current evidence, respecting and promoting diversity, and prioritising reflexivity and rigour in qualitative research. These recommendations aim to ensure that future studies reflect the complexity and heterogeneity of lived experiences while maintaining scientific and ethical integrity.