Logic Worn Thin: On Obesity as an Eating Disorder

It’s no secret that I heart semantics. I’ve written before about why “anorexic” is not a synonym for emaciated, why “asexual privilege” is inherently a misnomer, and why “fat” does not work as a verb. It’s true that I tend to twitch a bit, purely for English nerd reasons, when I catch language being misused. (My own tendency to misuse it aside. — Gasp! She’s human!  Look away!)  But I don’t dwell on semantics to police the way people communicate. I dwell on semantics to call attention to the ideas our words represent. Errors in the way we use language can — and often do — convey errors of logic and errors of ethics. And it’s those missteps I wish to challenge, when I’m (ostensibly) challenging our linguistic missteps.

So, today: obesity as an eating disorder.

Increasingly, among eating disorder activists and their mainstream appropriators, there’s a trend toward thinking we should fight fat stigma by treating “the obese” as we do those with EDs.  But the treatment of obesity as an eating disorder is fundamentally flawed.  In fact, it’s a perspective I firmly believe is influenced by the anti-fat stigma it claims to address.

For starters, “obese” (which I have to put in quotation marks, given its basis in BMI, a system with little to no medical value) — describes a physical body type, — while anorexia, bulimia, EDNOS, and BED describe behaviors and pathologies. How does one compare a body type to an illness, exactly?  Generally, by assuming that the fatness in question was caused by unhealthy eating behaviors. (To be blunt, people assume Fat People Are Fat ‘Cause They Binge, despite the fact that — as many of us in the ED community know — people of all sizes can binge.)

There is a valid comparison between “eating disorders” — like anorexia, bulimia, and EDNOS– with their fellow eating disorder Binge Eating.  Comparing these disorders — and discussing when and how it’s ethical/ logical to treat one of the four disorders the way you would treat another — makes sense.  When we do so, we begin important conversations about what our models — of treatment, of activism, even of illness — look like and how they might need to be changed.  Bringing Binge Eating into the equation helps us to question, for instance, our diagnostic criteria for eating disorders, what we consider healthy eating, and what we consider healthy food. All of this makes sense.

What does not make sense is to compare a set of behaviors or thought patterns — say, all the pathologies associated with anorexia — to a body type — for example, the “obese” frame.  This does not make sense because many, many people who have healthy relationships with food remain “overweight” or “obese” by BMI standards. In part because BMI is a statistical measure developed based on a limited sample, then generalized to populations its development didn’t consider, and applied in a medical context in which it appears to have no predictive value. (In other words: it’s being used to predict health concerns, a purpose it wasn’t designed for, for people it wasn’t designed to address. Science fail.)

Treating obesity like an eating disorder also presumes that all people who do not binge are thin. (He’s fat because he binges; she’s thin because she doesn’t.)  We know this isn’t true.  We know, increasingly, that shoring it up facilitates fat stigma and fucks with the lives of living, breathing, fat people. And yet, when we decide to be Totes!Progressive by treating obesity as we would anorexia, we support this perspective in doing harm.

Even those in the ED community who aren’t yet on board wth Fat Acceptance and Health at Every Size — (joinnnnn usssssss)– can recognize that not all people with eating disorders are thin.  The notion that having an ED — epecially anorexia — inevitably means being thin is one that many of us find painfully cumbersome.  So why reify it?  Because — honestly? — that’s what we’re doing.  We cannot compare obesity to an ED without suggesting that obese people cannot *have* eating disorders, as we normally understand them. For instance, “obese” people cannot have anorexia. If we believed “obese” people could be anorexic, we would not be discussing a “comparison” between situations at all. Because the situations would not strike us as “different” enough to compare. We never search for common ground without first assuming difference.  When we look for similarities between obesity and anorexia, we’re suggesting the two require that bridge of comparison. We’re presuming they can’t overlap (or co-exist) on their own.

We’re presuming, in short, that fat people aren’t anorexic. Because no anorexic people are fat. And all fat people (only) binge.

Even if we can’t see the anti-fat and eliminationist ideas guiding the “treat obesity as an eating disorder” comparison, we should– as people who know eating disorders — see that bias exposed when we flip the logic:  Would it make sense to us to force all thin people into eating disorder treatment?  Would we accept that approach as logical and offer our support?  Of course not.  Because we know that not all thin people have eating disorders.  We even know, sometimes, that thinness isn’t inevitably the result of eating habits.  What we don’t always know — to our detriment and to the detriment of fat people specifically — is that fatness is not often the result of eating habits, either.

We owe it to ourselves, and to those we seek to serve, to understand that people of all sizes can eat in a healthy way — and grow, shrink, or remain as they are, size-wise, regardless.  Anything short of that — anything that sets up fat people as the Other, anything that minimizes their ability to be (much like thin people) sick or healthy — is not an ethical approach.

And until we quit supporting — through action and through language — this understanding of Fat people as Other — Ima continue to throw this-here bitchfest.  This hissyfit.  This [whichever word best describes my shaking head, my crossed pair of arms.]

And I’m hoping you’ll throw it with me.