Daily Dosage: Healthy diet or psychiatric ailment?
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There’s been a lot of talk about the imprecise and ineffective criteria to for eating disorder diagnosis that’s offered in the current Diagnostic and Statistical Manual of Mental Disorders. For example, a woman can’t be diagnosed as anorexic without losing her period and being thinner than 85 percent of her peers. Which means self-starvers who stay shapely won’t be getting any insurance coverage for treatment.
But the demands for more thorough inclusion of eating disorders in the new edition of the DSM might hit too close to home for many Americans. Orthorexia is a term first coined by Dr. Stephen Bratman, and describes those with a fixation on pure, healthy, clean eating. And ED advocates want the ailment deemed a psychiatric disorder. No, those who are being labeled with the issue aren’t just counting fat grams, but how much of these diagnostic criteria sound familiar to you?
-Planning the next day’s food in advance
-Caring more about the “virtue” of a food than the pleasure taken in eating it
-Looking down on those who choose fewer healthier foods than you
-Guilt when you break away from your nutritious plan and eat something off-limits
Seems to me that many so-called “orthorexics” aren’t different from your average diet-obsessed Americans. It’s no secret that we’ve got a warped and wacky weight, food and fitness crisis. And when my husband worked at raw foods restaurant, I met some men and women who clearly had an unhealthy health-food fixation. But do millions of Americans obsessing over South Beach, celery and tomorrow’s dinner date suffer from a psychiatric ailment, or are eating disorder activists taking their crusade too far?
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No, it just means anorexics will starve themselves and exercise even more furiously until they reach that stage. This just creates an official, concrete “goal” for them to reach. And what’s this “peers” nonsense? Who are a girl’s peers… her friends, who might very well *also* be anorexic, and already in competition to see who can be the skinniest? Her school, or city, or state, or region of the country? Those of her race?
This is really stupid and incredibly dangerous. It creates an *officially recognized* “Yay! No period for the ____th straight month!!” “victory”. Now it’s not just bragging rights, it’s THE GOAL. At a time when so few people have any health care at all, and eating disorders usually aren’t part of even that paltry subset, this is going to kill a lot of girls and women.
What’s the criteria for boys and men? And what about bulimics, what does the DSM say about them now? Could we get a link to this?
Oh rats, you can’t edit your comments. I meant to add this:
“her friends, who might very well *also* be anorexic, and already in competition to see who can be the skinniest? ” and now they’ll all be in competition to weigh only 85% of what the skinniest person weights. So the girl who was “winning” by weighing 2 lbs less than her 110 lb friends now must weigh only 85% of what they weigh (93.5 lbs). And then that will be the new threshold and they’ll all be trying to weigh 85% of *that* (79.475 lbs). If that’s who her “peers” are according to the DSM.
Hi Diaceo.
Right now, the DSM does offer diagnostic criteria for anorexia and bulimia. There’s just a lot of talk about throwing orthorexia into the mix, or broadening the definitions of anorexia and bulimia to include more people (as well as adding binge eating disorder). Here’s the link to that: http://allpsych.com/disorders/eating/index.html
I’m of two minds about all this. First off, broadening these definitions would force insurance companies to fund more treatment for more trouble people. But, as you say, it only fuels the fire of many “disordered” people. And, as I wrote, it might also overstep the bounds of a psychiatric ailment, in the case of orthorexia. It’s tough to draw a line between “healthy fixation” and “unhealthy obsession”…