Last week a study published in the journal Biological Psychiatry (love the name! um, what other kind of psychiatry is there?) made the headlines by proclaiming that the most prevalent eating disorder in the U.S. is binge eating disorder. It said that 3.5% of women have episodes of "uncontrollable eating" at least twice a week for at least three months at a time. In classic sensationalist style, BED is now bring described as the "biggest" eating disorder in the U.S.
I had binge eating disorder for much of my teens, 20s, and 30s. It didn't have a name then, or at least I was unaware of it. It didn't seem unusual to me; other women in my familiy clearly had it too. It wasn't a good thing, and I wanted to change my eating patterns. I saw various therapists and finally landed with a good one in my late 30s. I signed up for 10 weeks of eating sessions and wound up with 8 years of intensive, fantastic therapy. Somewhere along the way I stopped eating compulsively, and while I still overeat on occasion, I have a healthier relationship with food now.
I hardly noticed when I "recovered" from compulsive eating. My weight dropped a whopping pounds. That's about it.
Why am I telling you all this? Because I'm worried that the hoo-ha over binge eating disorder will add fat (excuse the pun) to the anti-obesity fire. And that's bad news for all of us, whether we're fat, "normal," or suffer from anorexia or bulimia.
I don't want to play the "which is worse?" game. But as someone with personal experience of both B.E.D. and anorexia, I have to say there's no comparison. B.E.D. isn't a good thing, but it doesn't disrupt your life. Anorexia, the most deadly psychiatric disorder, kills. And while some people maintain a facsimile of ordinary life while they're anorexic, most do not.
I'm not saying it's OK to have an eating disorder. But I worry when I see all e.d.s lumped into the same category and discussed in the same terms. It simply isn't true. Anorexia is a life-and-death diagnosis. B.E.D. is not.
More anti-obesity rhetoric won't cause the prevalence of anorexia to rise, but it might trigger more people who are susceptible into active restricting and anorexia. And it certainly contributes to the culture of thinness that reflects our overall disordered relationship with food and eating.
It can and does affect treatment protocols, too. In my experiences (and the experiences of many families I've talked to), I've seen how the culture and bias toward thinness extends into the medical profession--sometimes quite deeply. One of the dirty little secrets well known among families with anorexic children is that doctors consistently set target weights that are far too low for true recovery. Not surprising, when you consider that a third of all eating disorders specialists have suffered (or still suffer) from an eating disorder themselves.
So my fear is that all this uproar over B.E.D., and how it's the "biggest" e.d., will cause more grief for families who are struggling with the ravages of anorexia.