In Australia, the New South Wales government is introducing a quitline to help tackle obesity. You call them up, they tell you to stop being so fat, I guess. It’s going to be called a “get healthy” line. Because
fat /= healthy
fat = smoking (?)
There’s the unspoken implication here that people will call up for support when they’re in the midst of restricting their food intake, and forcing themselves to do more exercise — because they’re hungry, sore, exhausted, demoralized, and they need a cheerleader to convince them to carry on. Which, to me, bodes…not well. If you’re trying to make a change that could be both physically positive and enjoyable, but treating it like it’s the incredibly unpleasant task of fighting an addiction, then you’re fucked. You’re not going to make it, because you’re turning what should be a positive, self-affirming experience into an onerous, burdensome chore.
And also, eating is not an addiction. Food can be used in pathological ways, and people might need support to change that behaviour (a.k.a. “disordered eating”) — but eating itself is not an addiction. Let me explain.
There exist very intensely pleasurable biological pathways to reward animals for survival-enhancing behaviours. Like eating food, drinking water, licking salt, and having sex. Addiction happens when a non-essential, and in fact toxic, substance insinuates itself into one of those pathways, replacing the life-affirming behaviour with something life-diminishing. Even in the extreme throes of an eating disorder, food is not an addictive substance, and eating is not an addictive behaviour. The behaviour may be pathological, like a compulsion — but a compulsion /= an addiction. I believe Linda Bacon will address this in her upcoming book, but this has always been my understanding of the issue.
On the surface, the shades of difference between “addiction” and “compulsion” may seem purely semantic, but I’m afraid that categorizing basic survival behaviours — even when they become distorted into pathological habits — as “addictions” can lead to a dangerously slippery slope. At the bottom of that slope lies fear of food, fear of the body, and the moralizing of fundamentally amoral behaviours. (Though, of course, I don’t believe addictive substances need be considered immoral either — it’s just that humans commonly use the short-hand of “bad” — morally bad — to describe things that are potentially harmful. And because the consumption of heroin or cigarettes is not fundamental to sustaining life, there’s really no harm in labelling these things as “bad.” But food? Categorizing food as “bad” — morally bad — can be very harmful.)
Let’s put it another way — an eating disorder is a symptom of an underlying problem, possibly biological, possibly psychological. It is not purely a function of the substance, food, or the behaviour, eating. An addiction (though these often do have underlying biological and psychological causes themselves) can come about simply from exposure to an addictive substance. An unborn baby, with no psychological issues or significant biological impairments, can become addicted to a narcotic simply by being exposed to it in the womb. That is an addictive substance.
Sometimes people with iron deficiency experience pica, or a compulsion to eat non-nutritive substances. It is their body’s messed-up way of signalling that there is a deficiency, that something ain’t right. These people will compulsively eat many different substances: ice, chalk, dirt, clay, even socks. Does this mean that socks are an addictive substance? Do they need to go to sock-detox? Or should they go on a low-sock diet, and maybe get some telephone support to help them stick to it, rah! rah!
No. They need to fix the underlying problem.
If someone has disordered eating — whether it’s an extreme eating disorder or a milder form of disordered eating, like overeating — they don’t need a diet, and they certainly don’t need a phone-line to encourage them to diet. They need therapy, training in some form of intuitive eating or demand feeding (possibly with some structure, as I’ve mentioned in the past — pure demand feeding doesn’t work for everyone), maybe medication, and they need Health at Every Size. It may not be a perfect, one-size-fits-all solution, but so far it seems to be the best we’ve got.
A phone call won’t stop the cycle. It’ll only give a push to another revolution of the diet merry-go-round we’ve been collectively riding for the last century. I don’t know about you, but that’s not the kind of revolution I’m interested in.