overeating – a neglected eating disorder

unhealthy habits and demographic changes are combining to place an unprecedented burden on the health-care system that may not be manageable, the heart and stroke foundation said in its 2010 annual report on canadians’ health.

so says the CBC about an alarming increase in heart disease and the potential for heart disease, adding `most of this is preventable.” the solution is

encouraging canadians to be more physically active, eat a healthy diet and be aware of their risk factors for heart disease.

“we all eat from stress, or because we don’t have time to prepare things,” said cheryl shapiro, a heart patient in toronto who was diagnosed with high blood pressure eight years ago.

she encourages people to read labels. “we don’t realize what we’re putting in our bodies.”

it is difficult to fit in the recommended minimum of 30 minutes of moderate-intensity exercise at least three times a week, shapiro said, but she does walk her dog regularly.

part of the solution is to create infrastructure to make it easier for people to walk to the store rather than driving everywhere to avoid exercise, abramson said.

“it’s easy to take shortcuts,” abramson said. “but in the long run, those shortcuts will be disastrous for our health.

there was a bit more about this on the radio but the gist was the same. what i found interesting – always find interesting about such news stories – is that obesity and being overweight is almost exclusively seen as a lifestyle choice. the equation of overweight = fat = out of control, unattractive, lazy, weak-willed etc. is not made explicitly but it’s really just three letters away. indeed, when i looked at the first five or six pages of the comments, i saw the word “lazy” six times. neither in the story nor in the comment pages did i see the word “eating disorder” or “addiction”.

i often get the feeling that in the world of psychiatric diagnoses, anorexia is much more noble than overeating. the overly thin person who uses her will power to deny herself a piece of broccoli is so much more appealing in our culture than the slob who sits in front of his TV, gobbling ice cream. of course both are caricatures and tell only a very, very thin slice of reality (for example, you could have two very similar looking people side by side, one of them struggling with undereating, the other with overeating. it doesn’t always show in the body size.)

there is controversy in the psych community over whether overeating is an addiction. i must say that i find NEDIC‘s approach in can i be addicted to food? just as naive as the above article. it ends up saying “once we begin eating in a normal, healthy way again, we won’t have the same desire to eat as much high-calorie, high-carbohydrate food, or foods we think are “bad”.” that sounds really easy, doesn’t it?

now of course “addiction” is just a label, so let’s not split hairs here (although personally i am firmly on the side of gabor mate’s definition of addiction, which would agree with the use of the word in connection with overeating). rather, let’s be clear on this:

there are many people who eat much more than they want to and are unhappy about it. they try and try and try and nothing seems to work. they experience things like this: they cry during binges because they hate that they are eating non-stop. they go to bed night after night with terrible stomach pains because they have eaten too much. they eat out of garbage bins, eat frozen and spoiled food. they go to great pains to hide their eating from others, often ordering nothing but a little salad when they go out with others. they go from macdonald’s to burger king to wendy’s, pretending they are buying for a family. they spend thousands of dollars on diets that work for a while and then go back to bingeing. they commit suicide over the shame they feel over their out-of-control eating.

this is not a little lifestyle problem that will go away with a bit of education and an admonishment to use more willpower. many people who overeat know a lot about nutrition already and know they should exercise more, just like many people who smoke know what their lungs look like. they are deeply unhappy that willpower doesn’t seem to work. my best friend’s mother, an astonishingly intelligent woman, died of lung cancer, greedily sucking on a cigarette just before she went into her last coma. while not every person who is overweight suffers with such intensity, there are nevertheless similarities. overeating, for many, is a disfiguring, depressing, despairing dis-ease that is difficult to fight. i wish that this will be acknowledged more in the coming years. come to think of it, MentalHealthCamp, our second conference on the intersection between social media and mental health, will be a great way to address this.

(this is another post for national eating disorders week)

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