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Abuse or Disease

  • Eating

What’s in a name? A recent letter to the editor in the Sarasota Herald-Tribune made the case that people should think twice about using the term substance abuse because alcohol and chemical dependence qualify as diseases. Of course, my thoughts immediately jumped to people who have an unhealthy relationship with food, so I spent a while thinking about the terms we use to describe them—anorexic, bulimic, binge-eater, food abuser, and disordered, dysfunctional, restrictive, over- or undereater.

How often when we use these terms do we view people has having a disease? Perhaps using the terms anorexia and bulimia, but hardly likely when we’re talking about restrictive or binge-eaters. If you’re a disordered eater, it sounds as if you simply need some straightening out, as if once you get things in order, you’ll be fine. Dysfunctional also has the ring of behavior capable of being turned around. After all, if something isn’t functioning, we simply fix it to make it work, don’t we? Restrictive, over- and undereaters sound like pretty benign conditions. Restricting even has the ring of being in charge and over- and undereaters imply nothing about severity or consequences. Binge-eating sounds a bit more severe because binge implies loss of control. Only the term food abuse has a truly alarming ring, calling to mind sexual, emotional, and physical abuse and causing serious, lasting damage.

Are there any terms that accurately describe what a person with food problems goes through? Is there a better way to say what an individual has or does, especially if we believe that there is an underlying biological component to eating problems? How can we get across the physiological nature of the problem and still have it sound like something anyone could suffer from? Finding a name for an unhealthy relationship with food is no mere semantic exercise; it demands that we think about the cause of dysfunction, which includes biology, socialization, personality, and culture.

If any of you have a term you think appropriately describes people who have chronic food problems, I’d like to hear it. Please feel free to post your ideas in the comment section below. The purpose is not to rename conditions, but to find what seems like an apt description of you for you. It might be that we need different terms to explain different conditions—the ones that are rotten habits versus the ones that are passed down in our DNA, those that are acculturated through society and those that are physiological through and through. Although I don’t have time to reply to each of you individually, I welcome your thoughts.