So this article on “food addiction” as an explanation for compulsive overeating would almost be good, if not for — as usual — the reporting. The lede informs us right off the bat that this is not an article about eating disorders, it’s an article about why people are fat — and the answer is, as always, it’s usually their fault.
Obesity has long been blamed on weak willpower, overeating, genetics and lack of exercise. Now scientists increasingly are seeing signs that suggest there may be an additional contributor: food addiction.
Ooh, there may be an additional contributor to that oh-so-comprehensive list! Who knew?
And that right there sets us up for what’s wrong with the whole article.
I’ve written about this before, but it seems to be coming up a lot lately, so let me recap my stance on this issue. Binge eating and compulsive overeating are forms of disordered eating. As such, they are rare. They are utterly devastating to the relatively few people who suffer from them, just as any eating disorder is, and they deserve the full attention of researchers who specialize in eating disorders. The current “treatments” available — dieting, 12-stepping, and trying to figure out “what’s eating you” — are woefully inadequate. People who eat this way need help, and they’re not getting it.
A big part of the reason they’re not getting it is that these disorders (which are increasingly being lumped together as “Binge Eating Disorder,” though compulsive eating and binge eating are somewhat different behaviors) are commonly seen as the usual eating habits of fat people. All fat people are fat because they eat too goddamned much, says the crowd, even though that’s patently false:
“Most obese people are no different from non-obese people,” [Dr. Albert] Stunkard says. They are not eating because they are depressed or because they have a pathological relationship to food or to their parents. If all you had was their scores on psychological tests — if you could not actually see the people you were testing — you would not be able to decide who was fat and who was not.
Maybe the obese eat differently, gulping their food or skipping breakfast only to binge later in the day? But no, that also turned out not to be true. Some overweight people eat quickly, some slowly. Some binge, some do not. Some eat when they are stressed; some lose their appetites in those circumstances. And, in every case, thin people are just as likely as the obese to exhibit those behaviors. There is no behavior that is typical of the obese.
– Gina Kolata, Rethinking Thin
But the mainstream media doesn’t seem to have heard of Albert J. Stunkard, or any of the other researchers who have come to the same conclusion. To reporters — to most of us — the idea that fat people generally eat just like thin people is unthinkable. Fat people eat too goddamned much!
And so the fact that a small percentage of fat people can’t stop eating too goddamned much, because they’re dealing with a serious mental health problem — which can lead to serious physical health problems — goes ignored. Those people, like all fatties, are merely weak-willed. They, like all fatties, just need to learn to push away from the table. They, like all fatties, are moral failures.
Worse still, people with these disorders internalize that message and fail to understand that their eating habits are not representative of the average (shameful, self-destructive) fat person’s, so they don’t seek out what help is available. Every time I post something saying that most fat people don’t overeat and fat people can be perfectly healthy, the most insistent objections come from people who eventually reveal that they do overeat compulsively and are unhealthy because of it. And they just don’t get that their experience is the exception, not the rule.
Why? Because the distinction is so rarely drawn. When the culture keeps telling us that fat people are fat because they shovel buckets of food down their throats at every opportunity, there’s no reason for people who do have an eating disorder to believe there’s anything wrong with them beyond what the culture tells them is wrong with them: they’re lazy gluttons with no willpower.
Personally, I buy into the “food addiction” concept where these disorders are concerned, but only as an imperfect metaphor. Addiction amounts to a nearly unshakeable belief that you need a particular substance, when you know intellectually that you don’t. But “food addicts” do need food. Overeaters Anonymous attempts to apply the abstinence-based 12-step model to food addiction by encouraging abstinence from “trigger foods.” (Sugar and white flour are two of the biggies.) To my mind, though, that’s swapping one form of disordered eating for another; it maintains the obsession with food that’s the hallmark of any eating disorder. It deprives people of the opportunity to learn how to listen to their own internal hunger cues, rather than fetishizing certain foods and rejecting any food that doesn’t fit into a predetermined eating plan. That makes me incredibly uneasy as a solution to disordered eating — although having said that, so little is known about these disorders that I can’t be sure a step like that is unnecessary in the first stages of breaking the cycle. I don’t really know what’s most helpful. Doctors don’t know. It’s fucking maddening.
But I can tell you what’s not helpful: articles about “food addiction” that seem far less concerned with discussing a largely overlooked eating disorder than with reminding fatties that IT IS STILL PROBABLY THEIR FAULT. The USA Today article ends with this:
Others pooh-pooh the idea of food addiction. “This is a dumbing down of the term ‘addiction,’ ” says Rick Berman, executive director of the Center for Consumer Freedom, a group financed by the restaurant and food industry. “The term is being overused. People are not holding up convenience stores to get their hands on Twinkies.
“Lots of people love cheesecake and would eat it whenever it’s offered, but I wouldn’t call that an addiction,” he says. “The issue here is the intensity of people’s cravings, and those are going to differ.”
Gee, thanks for the insight. Points to the author for noting who funds the Center for Consumer Freedom (which is why I never draw on them as a resource, even though they’re quite vocal about the obesity epidemic being overblown; I don’t like sources whose main goal is profit for large corporations, even if their reporting dovetails with what I’m trying to get across here), but why the hell does this clown get the last word?
Yeah, lots of people love cheesecake, but most of those people, even the fat ones, would not eat an entire cheesecake or two in one sitting. I love booze and take it damn near every time it’s offered, but I’m not an alcoholic (thank the fates). It is not a difference of “intensity.” It’s the difference between enjoying something in a healthy way (save the occasional hangover or tummyache) and making yourself chronically ill because you don’t know how to stop.
People who are immobilized by their fat and consumed by their eating behaviors are ill. And they are unusual. This article, like most, makes that distinction, but not to emphasize that people with Binge Eating Disorder need help and compassion — just to emphasize that other fatties aren’t off the hook.
Psychiatrist Nora Volkow, director of the National Institute on Drug Abuse, a speaker at the meeting, says the research in this area is complicated, but most people’s weight problems aren’t caused by food addiction.
And in case you missed that, or the opening paragraph, or the closing paragraph from a source the author fucking notes is questionable, she repeats Volkow’s position on this matter one more time:
She does not believe that most people are overweight because their brains’ dopamine systems don’t function properly.
Yeah, we get it. Most people don’t have this problem. Which is why this disorder needs more attention.
All right, credit where credit is due time: immediately after that, she at least acknowledges two factors that don’t rely on calories in/calories out. (“Genetic vulnerability and stress.”) And the quotes from researchers are lengthy, fair, and informative. And this one’s especially worth cheering:
“It’s surprising that our field has overlooked this concept for so long,” he says. “Society blames obesity only on the people who have it and has been close-minded to other explanations.”
Unfortunately, the slant of the article remains clear: we should be skeptical of people claiming “food addiction” exists, because it might make people who aren’t addicted to food think they have an excuse to keep being fat. So instead of shedding light on an issue that might help some people realize they have an eating disorder and are allowed to ask for help, the overall message is: you probably do not have a disorder, fatass.
Statistically speaking, that’s true. The vast majority of fat people aren’t food addicts. But when the ones who are can’t even recognize it, because all they ever hear is, “It’s your fault! Just stop eating so goddamned much!” a little more thought about how we frame these issues is in order. And if reporters truly believe that “Binge Eating Disorder is very real and devastating, and it’s been historically overlooked by eating disorder specialists” is a less important message to take from this study than “Most fat people have no such excuse for their fatness,” I don’t have much hope that that kind of thinking is gonna come any time soon.