Quora question: If anorexia is considered an illness, why isn’t obesity?

My answer:

Nothing tastes as good as skinny feels except brownies, pizza, gravy, mashed potatoes, cake, ice cream and life. 

Anorexia Nervosa is classified as an eating disorder in the DSM; the Diagnostic and Statistical Manual of Mental Disorders. Anorexia is intentional self-starvation. In order to receive the diagnosis, however, an individual must have a BMI that is essentially near death. As well, BMI is not a consistent or reliable measure of weight or severity of the distress a person may be experiencing as a result of not eating. A person may be restricting food, fearful of weight gain, over-exercising or obsessing about intake but not ‘qualify’ for the diagnosis. This has been a problem for years both for therapists and individuals seeking help.
Before the DSM-5’s release the only other eating disorder diagnosis available were Bulimia Nervosa (bingeing, purging or exercise bulimia), Eating Disorder Not Otherwise Specified (EDNOS; a diagnosis used when a person has a difficult relationship with food and/or body image but doesn’t meet criteria for Anorexia or Bulimia), and Pica; a diagnosis that often indicates an underlying medical condition like anemia in which a person craves non-food substances such as a desire to eat dirt or clay. This isn’t a complete explanation of all the diagnosis where food or body image issues might come up but for the sake of time let’s get to your question about obesity.

Obesity is a symptom. Let me say that again: Obesity is a symptom not a disorder. It’s often linked to compulsive overeating or bingeing that is not always but sometimes accompanied by purging, compulsive exercise or cycles of restricting after bingeing or periods of normal eating. It’s also sometimes accompanied by guilt, shame and secretive behaviors to hide the need or desire to continue to overeat. Not acknowledged anywhere in the DSM is the role of a feeder; a person or persons who support a compulsive overeater by purchasing, preparing and sometimes physically feeding an individual who may be so obese they cannot perform these tasks without the assistance of a feeder; much like an enabler in other forms of addiction.

Ongoing controversy between medical researchers, the FDA and food corporations to classify white sugar and certain man-made food products and additives as addictive substances contributes to complications with eating disorder diagnosis and treatment. This would require foods like certain cereals, cookies, chips, basically all boxed or ‘fast foods’, juices, sodas etc. to come with a warning label with information about how those products are linked to an increased risk for diabetes, obesity etc. Overeaters Anonymous has been prescribing a sugar-free, whole foods diet as part of helping people manage compulsive overeating for over 50 years because they acknowledged many of us use those foods as a coping substance. If such labeling were approved binge eating and possibly other eating disorders may have moved into the addictions section of the DSM which could lead to requiring insurance companies to pay for eating disorder recovery treatment the same way they cover services for other forms of addiction. As it stands, Binge Eating Disorder appears to blame the individual for an inability to stop eating, as opposed to acknowledging that we may under or overeat because of unaddressed medical issues, trauma, laundry, toddlers, traffic, bills, bosses, bake sales, Super Bowl Sunday and probably Thanksgiving.

Meanwhile the battle rages on; diabetes and other obesity related medical conditions continue to rise and people are not receiving the informed help and care needed to combat behaviors which are rooted in the need to feel safe and a part of the world.

In short, we overeat, starve, purge and compulsively exercise to cope with life in the same way a person might turn to drugs or alcohol. It is not our fault and we can recover from these behaviors, if we want to, using a combination of medical care, mindful self-compassion, therapy and sometimes appropriate medication. Many man-made food products are addictive substances which have been proved by validated research which our government and food corporations refuse to endorse in favor of profit, just like alcohol and tobacco companies had done for years. Knowledge is power. While we continue to advocate for truth and validation we can take personal responsibility and seek alternative forms of help. Overeaters Anonymous is a great, free 12 step resource that has helped many people heal thier relationship with food.

From the APA: “In a letter to the editor published in Psychiatric News in 2005, Chodoff proposed a new diagnostic entity for DSM-V that he titled “The Human Condition.” The diagnostic criteria included, among other symptoms, “dissatisfaction with one’s looks and sexual performance” and “getting upset when things go wrong” (Chodoff, 2005). The diagnosis, he wrote, would facilitate insurance reimbursement, eradicate the problem of comorbidity, and “encourage the quest for a drug to cure the disorder of being human.”(He was kidding.)

 
Fun controversy about the DSM-5, big pharma and the government:

https://www.motherjones.com/environment/2015/07/binge-eating-disorder-vyvanse-adhd/

https://www.google.com/amp/s/www.marketwatch.com/amp/story/guid/760DB900-CD43-11E2-A536-002128040CF6

https://mobile.nytimes.com/2015/02/25/business/shire-maker-of-binge-eating-drug-vyvanse-first-marketed-the-disease.html

http://sitn.hms.harvard.edu/flash/2015/natural-and-added-sugars-two-sides-of-the-same-coin/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477992/

https://books.google.com/books?id=AuPdBgAAQBAJ&pg=PA17&lpg=PA17&dq=DSM-5+board+member+resigns&source=bl&ots=PAD7cC6Lqg&sig=NOJNa3w-hfLOlzqCt7KVZlbTmg0&hl=en&sa=X&ved=2ahUKEwjoj_SbyNPZAhUB5mMKHWZnAss4ChDoATAGegQIARAB#v=onepage&q=DSM-5%20board%20member%20resigns&f=false

https://www.karger.com/Article/Fulltext/357499

29 thoughts on “What the Fork?

  1. Its interesting as in the book I was reading Lost Connections Uncovering the Real Causes of Depression and the Unexpected Solutions he addresses obesity and said in every case a purely dietry approach does not help as the underlying issue has to do with nuturance or abuse. Its pretty clear to me anything connected to do with food is about nourishment and when we eat too much what does that say about the level of emotional starvation within. The literalism of our society downright breaks my heart..

    Liked by 4 people

  2. Fabulous piece! This would be excellent in the Health section of a serious newspaper. Or as a guest piece in The Guardian online. Deserves far and wide publication!

    Human Condition, hee hee.

    Total aside: You know how laughter is the best medicine? If that’s the case, the British food series “Supersizers Go” deserves evaluation for therapeutic benefits:

    https://en.wikipedia.org/wiki/The_Supersizers

    Liked by 1 person

    • Aww Sophie. Thanks but you might overestimate me. Haha. I just wanted to get this piece over so I could write about my dream. Thought it was clunky but thanks again. And yes, I agree laughter is the best medicine. I’ll definitely check out the link to the show. There’s another one I’ve watched on YouTube from Europe where super skinny and overweight people get paired up to switch meal plans. I’ve always been fascinated by the two sides of the same food coin. Thanks again and cheers!

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      • No overestimation. I spent nearly two decades grading essays and examination papers at secondary and tertiary levels and know an A+ when I see one. Also we read widely in this household. 🙂 Your piece is better than the average nutrition/psychology/society piece that appears in the Australian press. It’s on a par to what we read in the Guardian. Why don’t you submit it to them and see what they say? Perhaps you underestimate yourself. 😛

        In my experience, the people who are truly good at something tend to see underestimate themselves, while many mediocre people have these inflated views of their work. Have you heard that saying for women, “Carry yourself with the confidence of a mediocre white man”? Since as you can see for yourself, these are the ones who mostly have the power and make the decisions in our society. If you’re looking for extraordinary people, don’t look in the parliament, for instance – it has a low strike rate! 😉

        Liked by 1 person

      • Well thanks teach. I’m not familiar with that saying but it could grow on me. The over-under estimation you describe has another definition; the Dunning-Krueger effect. Learned all about it after the election in America when I was trying to understand what happened. Hmm, life as a mediocre white man…makes me think of a film you might love called The Invention of Lying. Ricky Gervais goes from mediocre to great with a few fibs. It’s hilarious. 🙂

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    • That’s exactly it Jaqueline. There’s always a reason underneath our behaviors. The goal is to have more of our behaviors motivated by love and less by other feelings.

      Like

  3. It all boils down to love or rather lack of self-love. That may oversimplify it but I truly believe that the way we choose to nourish ourselves whether it be denying our bodies any nourishment or overeating to the point of being sick is directly linked to the amount of self love (and healthy coping skills) we have. I have been both underweight and overweight and my relationship with food is the same as it was with alcohol. When I got sober in my 20s I turned to bulimia to numb my pain.

    Liked by 2 people

    • Nothing simple about love. What you said is right on. I roam around with addictions too; codependence, perfectionism, restricting, exercise but my favorite is smoking haha. Ugh. We’re just trying to fill the void where love wants to be. Hope we all get there ❤️

      Liked by 1 person

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