Obesity is an eating disorder.

Ice Queen commented on one of my recent blog entries. The whole comment was good, but this part hit me like a brick:

"If the eating patterns that get a keep a person obese isn't disordered eating, I don't know what is."

Truer words were never spoken. There's great pleasure in eating, no doubt about it. But that's not why people become nor remain obese. Fundamentally, it's a highly unhealthy relationship with food. What most people don't know is that the painful feelings due to hunger can sometimes be pleasurable to an anorexic. Yes, sounds crazy, but anorexics aren't normal. There's a high to it. When we're dying of hunger, it means we're losing weight. That makes us happy. When we're dying of hunger and don't eat, we're showing we can control the most basic of desires a human can have. That means strength and control to us--a control we have nowhere else in our lives. I suspect that at least some of the time, it's as pleasurable as eating is to an obese person. But that's not why we become anorexic. It's disordered eating, just as it is for the obese.

That's why I insist that obesity is an ED.

It's also been shown that obesity frequently has crossover with the other EDs. As in anorexia, an obese person often feels she's not in control of large parts of her life. She can eat to comfort herself for that anger. They often binge; in fact, I'd say they all binge. That gives them Binge Eating Disorder. Not all purge, but a number do, making them bulimic, too. Binges are definitely self-medication. Compulsive Overeating Disorder is a frequent addition to obesity. I can't imagine that any obese person doesn't have COD. In fact, other than the anorexics, the people at OA meetings all discuss their COD.

So why isn't obesity termed an ED? I think it's because even today, not to mention two hundred years ago, it was seen as a moral failing by lay people (and was by medical and religious people, too), not as a mental illness. The obese are still seen as weak, lacking in self-control, normal but lacking in basic character, etc. I've known people--my therapist is one of them--who see anorexia that way, but nearly all people in the mental health field disagree. I'm seeing the tide turn with obesity in modern medical research of obesity. It's a physical, mental, and emotional illness, with genetic, neurological, and psychological aspects. There's no moral component whatsoever. As several of my blog entries have addressed, obese people are practically hated. It's crazy. I have some ideas about why that's so, and will probably post about that again later.

When reading so many of the weight loss blogs, if you do as I do, you'll see the bingers are everywhere. A few are bulimics and should be receiving medical care for that in rather than, or in addiction to, obesity, IMO. COD is rampant. That should be treated, too, or else the obesity will persist--once again, IMO. Oh, anorexics binge, too, but on a much lesser scale. A binge for an anorexic can be as little as 500 calories, or as much as 1,500 calories, nothing like the tens of thousands an obese or bulimic person will eat. Since a "regular" obese person won't purge, and obese people have more efficient digestive powers, that adds weight quickly. Bulimics tend to gain more slowly, and their binge/purge cycles are a little different. They can easily binge/purge a dozen times in one day, something an obese person will almost never do.

I know this is rambling all over the place and apologize for that. But one thing leads to another. What I'm essentially trying to emphasize is how much of obesity is wrapped up in the other EDs--so much so that ignoring that is a disservice to the obese, and why I think it's so difficult to treat.

You know, I haven't talked about people who are overweight in this blog, and only rarely mentioned them. I'll get to them in the future. I just want you to know that I'm always aware of them, and not ignoring their problems. Obesity and anorexia are life-threatening, however, so while the problems of the overweight are important, they're not dire. Anorexics have the highest death rate of all the EDs, but obesity isn't too far behind. They must come first.

As I wrote initially, I think we're all in this together: the obese; anorexics; those with BED, COD, bulimia, etc.; and all of the EDs. We have to band together and force the medical experts to see that obesity is treated the same way as the other EDs. We have to educate laypeople to understand that obesity isn't something to be hated, feared, or its victims to be seen in a terribly negative light. We really have to make laypeople--especially young women--not see anorexia as something desirable, a choice, and something to be aimed for.

Obesity is a sign of disordered eating, an unhealthy relationship with food--an ED. For real. It's not a choice. No one ever decided at age 5 to be obese. No one binges in an out-of-control way in order to get to 350 pounds. No one joins an obesity blog ring to get tips on how to gain weight. (Anorexia websites are filled with such people, as sick as that is, although it comes from pure ignorance.)

Fat is not disgusting. Thinness is not desirable. Normal is the thing to aim for. For the average person, that's a normal BMI. At 5'4", my range is 108 to 145 pounds, a very wide range. It's not 88 pounds, which is what I want to weigh right now. Oh, and when I get to 88, I'll want to weigh 85 or 83--that's the nature of anorexia. I don't want to die, just as an obese person doesn't want to die. Death is irrelevant in these diseases until the desire for health steps in and says, "No more. I'm getting off this road to death right now." Then, and only then, can recovery occur.

I hope I haven't bored you here, but this is very important to me, that the obese and those who are traditionally determined to have EDs get together and fight these diseases.

What do you think about this? I'm really interested in what you have to say.