DANGERS OF MAKING TOO BIG A MEAL OF EATING DISORDERS

August 16 2006: This is a difficult one to write as it is going to upset some people no matter how I say it but, hey, when has anyone agreed on just about anything when it comes to dieting and eating problems?

Eating Disorders are undoubtedly horrid and quite often life threatening but pushing too many problem eaters and hardcore dieters towards definitive Eating Disorder status may be causing harm. 

There is the beginning of an Eating Disorders bandwagon on a dangerous roll.

Problem eaters and dieters are being placed into medical categorisations, limiting abilities to self-help and recover.

Exaggerated claims about the extent of eating disorders, born of over-zealous diagnoses, are fanning the flames of food distress (at the outset let it be clear that we are not pointing the finger at the many research-driven or reasoned advocacy or research groups).

But becoming quite commonplace are predictions that 30-50% of women will experience an eating disorder some time within their lifetime.

I do not for one minute believe that up to half of women will suffer an eating disorder. However, what I believe matters not at all; if people expect themselves to be at risk, then risk automatically increases. If that risk is quasi-medical, it assumes a certain inevitability. And if that risk gains a grave sounding status, then that's just typical of our bad luck that we've caught it, isn't it? (And if other people have it, what makes them so special that we can't have it too?)

This is pathologising on a grand scale - the categorisation of problems or conditions into disease. Once issues become concretised like this, the focus of remedy changes. It goes from being voluntary habit change to becoming treatment by third parties.

Beyond this there is a credibility issue. It is incredibly easy to be condemned as reactionary or uncaring when criticising the voices of any minority. However, history shows that any overstatement or inaccuracy risks damaging the core cause. One only needs to look back to the Gay Rights movement of the 1970's and 1980's to remember how some perhaps over-enthusiastic estimates of the population's gay percentage led to opponents shifting the field of debate. With this one area of accuracy challenged, the otherwise overpowering core case for equality and decency was less clearly advanced.

Until recently, definitions of eating disorders have generally comprised Anorexia and Bulimia. Whilst there are various earlier references to self-starvation, particularly in young women, going back to classical antiquity, it was not until the latter part of the 19^th Century that a medical typology of Anorexia was first constructed. Bulimia was first formally noted at the end of the 1970's.

The research community has for some time explored 'Binge Eating Disorder' to capture the notion of repeated and out of control overeating. BED as a concept is now ring-fenced with a considerable array of necessary behaviours, anxieties and obsessions to differentiate it from lesser overeating.

Despite the cautious progress of researchers in testing the boundaries of eating disorders, there is a less-sophisticated eating disorders bandwagon creating a disruptive momentum. As ever, the media is a ready recipient, promoter and sometimes creator of sensationalism in all things eating problems related.

Individual issues of self-image anxieties, overeating, continual dieting and obesity concerns are being conflated into broad-ranging quasi-medical conditions. Whatever the label, these behaviours and conditions are painful. But the label does matter hugely in how they are addressed (and acquired and perceived).

This is not to downplay for one minute the dangers and distress caused by full-blown eating disorders, including serious binge or compulsive eating. However, people can often summon a far greater control over what is personal and cultural than they can over what is becoming to be seen as endemic and medical. Wherever the serious debate finally settles with some certainty in these areas, it is absolutely clear that there is too much hype seeping in at present.

The more that people are over-hastily pushed down the road of disease labelling, the lower are their chances of establishing and maintaining a natural and relaxed relationship with food.

Sometimes the self-elected carers need to exercise more care with words.