Thursday, February 24, 2011

Why Dieting Is Disordered Eating

photo by: Danbwr Photos
What is Dieting and What Is Disordered Eating?

America, as well as many privileged countries, are having a love affair with dieting. The dieting industry is a multi billion dollar a year industry. They spend copious amounts of greenbacks playing on our worst fears, hyping up false health scares, and convincing us that all of our problems would just go away if we weren't so freaking fat.

Okay, so what is disordered eating? The simplest definition is that it's  an irregular eating habit. In other words, if you're not eating for sustenance and pleasure- then your eating habits are irregular. This can include emotional eating, calorie/food deprivation, and yes, dieting. Disordered eating is not an eating disorder, but they are connected and disordered eating often leads into eating disorders

What is dieting? Dieting is an exercise in control- a common denominator with eating disorders. The most common form of dieting is calorie deprivation. Other than the fact that dieting makes you gain weight, not lose it, long term calorie restriction can lead to severe health problems. So- obsessively counting calories/fat grams/carbs for the purpose of altering your physical appearance. That is dieting. 

Well, what's wrong with that? Firstly we can start off by saying that dieting and weight loss as firmly grounded in the superficial and vain- and I don't just mean the dieters but all of society that encourages, pressures, and expects people to look a very certain way, especially women. First let's get rid of the excuse that dieting is for health. People who are really changing their eating patterns for health don't diet- they engage in healthful eating behaviors by incorporating more healthy foods and limiting unhealthy ones. If you are on a traditional diet solely for health benefits then you are bigfoot-rare and probably aren't the type of person to read a blog like this anyway. Although I should warn you that if you're doing it for health- you're not going about it the best way (see the above links). In reality, even if some people hide behind the "it'll improve my  health", let's be honest, if you got healthier but didn't lose any weight, how would you feel? Disappointed? Frustrated? Depressed? Then your real reason was to be thinner. Ignoring your body's natural weight and trying to push it below that, then that's not natural eating. It is disordered eating.  What is natural eating? It is eating for sustenance and pleasure as well as paying attention to internal cues for what your body needs nutritionally as well as cues for hunger, fullness, thirst, etc. Dieting means ignoring hunger, ignoring nutrition (ignoring calorie needs is the most common but low carb diets come in a close second. The daily recommended amount of carbs is around 300 where, for example, some Atkins patients in the 'first phase' are restricted to about 20) and having an unhealthy focus on food. 

Disordered Eating And The Line Into Eating Disorder

Susan Schullherr, LCSW, an advocate for the rights of patients with eating disorders, in an interview on PsychCentral, says that "Dieting sharply increases the likelihood of crossing the line from disordered eating into eating disorder". One of the most pervasive causes of disordered eating, she says, is trying to adhere to an unrealistic social ideal of thinness. Sounds familiar doesn't it? While I love the BBC Documentary "Why are thing people not fat" for it's ability to demonstrate how thin bodies handle excess calories and limited exercise, one of the most disturbing parts of it is that the participants all began engaging in aspects of disordered eating after the experiment was done- obsessively counting calories and fixating on what foods they could or could not have as opposed to their original behavior of just eating whatever they felt like and listening to internal cues (something that kept all of them thin and lean because that was their natural body type and weight).  This highlighted just how afraid people who engage in disordered eating are of food. If you're afraid of food- you can be sure that you're not eating naturally. 

People have stopped thinking of food as this great thing that is necessary for survival, health, and, indeed, can even be pleasurable and they've started thinking about it in terms of being an enemy.  It's not what food does for you, it's what food does to you. Food is something you have to conquer, to fight. Hunger is an ambush, just waiting to mess up your entire life. And eating is a necessary action that holds your body as a prisoner of war. Someone please tell me how any of this can be considered a healthy relationship with food? 

EDNOS (Eating Disorder Not Otherwise Specified) is the less well known and less cared about eating disorder and the one that most dieters cross the line into. According to the DSM-IV (the standard for diagnostic criteria of mental illness), the criteria for EDNOS is extremely vague and basically states that it's any eating disorder which doesn't qualify for anorexia, bulimia, or binge eating disorder, however, some examples of criteria include:



Based on the limited technical criteria above, following are some additional examples of the behaviors associated with persons struggling with EDNOS. (Please note: this is by no means a comprehensive listing). *1

  1. You're always on a diet, always coming off a diet, or always getting ready to go on one again (chronic dieting).
  2. You categorize foods as 'safe' and 'off limits', but are not significantly underweight and are not participating in bulimia.
  3. You starve yourself regularly, but are not significantly underweight (i.e. less than 85% ideal weight)
  4. You eliminate entire food groups from your diet (yes, that includes carbs!).
  5. You are obsessed with exercising but eat fairly regularly.
  6. You binge and/or purge, but not more than once a week.
  7. You substitute supplements and fad diets for real food, but are not significantly underweight.
  8. You skip social occasions because you feel fat, or because you are afraid of what's being served, yet are not significantly underweight.
  9. You are obsessed with eating only organic, natural or raw foods (orthorexia).
  10. You believe that everyone is as focused on your weight as you are.
  11. You refuse to eat regular meals, choosing instead to 'nibble' throughout the day on small portions of food (which usually leads to binging).

Any of this sounding familiar? At this point it's easy to point out that if you're fat you're expected  to exhibit these behaviors. It's only an issue when you're already socially ideal- according to most people. But psychologically the process, the emotions, and the pain and obsession are the same. Of course, if you go and see a therapist who specializes in eating disorders they're likely to diagnose you with EDNOS whether you're fat or not, but the baseline information shows a significant bigotry against fat people. We're supposed  to starve ourselves and obsess over food, right? Because accepting our fat means accepting laziness, and gluttony.  

I spoke with nutritional anthropologist Leah Baskett from the University of Arizona who said, "I think in our society fat people can't have ED, period....If you're fat, and if you do not keep a food journal, weigh yourself all the time, ruminate over every single bite of food, and absolutely despise yourself for having any needs and despise your own body for having needs (esp. the need for food), you are a piece of shit." And I agree with her. Because these behaviors are expected in fat people and you're a "bad fattie" if you don't engage in them, then we end up thrown into a world of disordered eating that's not acknowledged as disordered eating. A "good" fattie is someone who's properly ashamed of their weight and making every (futile) effort to conform to the societal ideal. 

So, if chronic dieting is considered a symptom of an eating disorder, then dieting in and of itself can certainly be called disordered eating. Especially since it doesn't achieve that which the dieter hopes for- health and lasting thinness. Baskett noted, "Every diet (or as they now label themselves, "lifestyle change") group I ever was a part of....did not discourage disordered thinking about food: on the contrary, they actively encouraged and promoted it." Linda Bacon, PhD and author of Health at Every size, told me, "Absolutely, I believe that dieting is disordered eating. As I write in Health at Every Size, "Any system that emphasizes external processes to determine what to eat is fragile and ineffective and promotes discontent and periodic rebellion and binging." I'd much rather support people in honoring their intrinsic drive to take care of themselves."


The bottom line seems to come down to the idea that fat people can't have eating disorders and the only form of disordered eating they can have is overeating. When people who aren't of the social ideal engage in disordered eating/eating disorders it is considered good. It means they are properly ashamed of their grotesque form and trying to become a good and better person. The fact that we promote disordered eating in anyone is worrying and is detrimental to both physical health and mental health. I would argue that the mental health damages of diet culture and body shaming is far worse than any physical health damages that are perceived by the general population. 


 Dieters who aren't underweight are the silently abused. Abused by an industry that profits from their pain, abused by a society that places worth and value on appearance and weight, and abused by themselves as they internalize the vitriolic messages about their bodies. Body acceptance and, yes, fat acceptance, is the only good way to combat these unhealthy relationships and feelings with and about food. While we should all be informed about our food choices and be aware of what goes into our bodies, food should not carry feelings of guilt, shame, or disgust. 

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