UNPOPULAR OPINION: The Medicalization Of Eating Disorders Is Keeping Us Sick

It wasn’t until months after I left OA that I finally challenged the validity and utility of my “Eating Disorder” label. Is identifying myself as an “Eating Disordered” person for the rest of my life really serving me?
Publish date:
January 23, 2013
food, eating disorders, food guilt, recovery, overeating, disordered eating

Let me be clear: I had a raging, clinical eating disorder at one point in my life. I lost 40 pounds over the course of one summer while railing Addy and cocaine until I was kicked out of college and told that I wouldn’t be invited back until I got some help. I was also binge eating and throwing up my food most of high school. Ya know, the usual diagnostic criteria.

I was treated at a really bourgie medical treatment center, not dissimilar to the ones that MK and Lindsey went to (and it was around that same time -- rehab was in vogue).

All jokes aside, I am deeply aware that I needed to go. There is no way in hell I would have stopped doing drugs had I not gone, and it is a terrifying nightmare to think about where I would be now without some drastic intervention.

When I was finally released from treatment, I identified myself 100% as an eating disordered person.

Hi. My name is Isabel, and I have an Eating Disorder.

It became a part of who I was. And that protected me for a long time.

“Sorry, I can’t go on a diet, I have an eating disorder.” (Probably a good call.)

“Sorry, I can’t step on a scale, I have an eating disorder.” (Also, probably a good call.)

But at some point, after I had taken control of most of my self-harming behaviors with food (i.e., I was clean, and not throwing up), “my eating disorder” label started to become a Frankenstein. I was obsessed with managing “my disease,” and “recovery” became a new addiction.

I would go to Overeaters Anonymous meetings (my step-down program of choice) and wax poetic about “my eating disorder,” even though I was no longer engaging in self-harming behaviors other than binge eating, which I have since learned is often a symptom of believing that something is wrong with you.

More to the point, I believed that I would be eating disordered forever.

“I can’t go on a diet, because I have an eating disorder,” became, “I will never have a healthy relationship with food, because I have an eating disorder.”

Eventually I left O.A., not because it was keeping me in the small bubble world of “recovery,” but because I stopped believing that a “plan of eating” was a good idea. I got to a point, where I knew I didn’t need to be on a meal plan for the rest of my life, and l started to see my “meal plan” for what it was -- a fucking diet.

The “disease model” was not why I left. That part I still very much clung to. It wasn’t until months after I left OA that I finally challenged the validity and utility of my eating disorder label.

I hired a private coach (who shall not be named) to teach me how to “eat intuitively” and “trust myself around food” (which, for the record, is what I believe recovery actually looks like).

One day, this woman looks me straight in the face and asks:

“Why do you keep saying you have an eating disorder? You don’t. Stop saying that.”

BOOM. Fucking. Breakthrough.

And that’s when I started to question it -- is identifying myself as an eating disordered person for the rest of my life really serving me?

Are eating disorders really chronic illnesses that we have to manage for the rest of our lives?

At what point is it appropriate to put our “eating disorder” label in the past, and join the ranks of 90% of women -- the place where sometimes we “feel too fat” or eat our feelings, or think dieting might be a good idea when it’s not, but mostly, things are OK?

At what point is it acceptable (or even helpful) to declare yourself “recovered” with a “D” at the end, rather than “recovering?”

I soon learned that there is a growing movement in Psychotherapy that functions under the assertion that diagnosing “mental illnesses” the way you might diagnose a physical ailment is rudimentary at best, and may actually be harmful to patients over the long-term.

“It's very different to say our actions are unhealthy versus we are unhealthy” says Sheryl Canter, counselor and author of Normal Eating for Normal Weight. “If we're just doing something unhealthy, we can stop. But if we are unhealthy, we're doomed.” (She says this on her website, where she critiques the “Disease Model” of overeating in OA).

“There are a growing number of psychotherapists who don’t diagnose, and who advocate a movement away from...mental health diagnosis,” says Matt Lundquist, a New York based, non-diagnostic therapist. Lundquist asserts that one of the primary flaws with mental health diagnosis is that it assumes that the problem lies within the patient -- it “assumes that you are the problem.”

As I did more research, it became clear that there is concern amongst psychotherapists that the “internalization” of a mental health diagnosis -- i.e., a patient’s belief that something is fundamentally wrong with them -- may have a negative impact on their psyche and behavior.

In my case, my eating disorder became a constant, cyclical, self-fulfilling prophecy.

And I understand that a bunch of people with newfound eating disorder pride are about to freak out at me right now. I know countless women who believe, like they believe in God, that the moment they relinquish their eating disorder title is the moment they’ll relapse into the worst trenches of “their disease.”

And maybe that’s true for them. Or maybe that’s true for them right now.

Lundquist does acknowledge that a diagnosis may have a positive impact on behavior, particularly in the early phases of treatment (e.g., “I can’t step on a scale, because I have an eating disorder”).

“A diagnosis can give hope,” Lundquist says, by communicating to patients that their experience is shared by others. It may also be “an essential part of being honest about what’s going on and what kind of decisions need to be made in order to maintain health and safety.” That is, know what denial looks like, and don’t forego treatment when you need it.

Ultimately, however, Lundquist believes that a diagnosis should not determine the course of one’s treatment indefinitely, and he “takes pains not to relate to patients as problems, or to relate to the challenges they’re having as a simple function of a category in which they’ve been placed.”

At some point, it was incredibly important for me to let go of my eating disorder label, so that I could believe in myself to eat like a “normal” person.

I am not broken. I can (and do) eat like a “normal” person today. And it’s this deep knowing that “I am okay” that brought me my greatest healing around food.

For the record, I do not believe that Alcoholics can drink like “normal people.” I really can’t speak to that, but I do know that there is a difference between substance abuse addictions (like alcoholism) and process disorders (like sex or eating disorders). It drives me BANANAS when they get clumped in the same category.

Today, I am capable of making healthy choices for myself on a moment-to-moment basis. I write a funny blog for the 90% of women in the world who are NOT eating disordered, but want to have a healthier relationship with food and their bodies.

These are my people now. I am not abnormal.