Why Must People Pathologize Eating Problems?


Editor’s Note: This post was updated by the authors on February 26, 2020.

The latest issue of the Sunday New York Times (February 9, 2020) had a full-page essay in its “Modern Love” series, in which writer Lauren Covalucci, an intelligent, self-aware woman, describes having been shamed since age three in her ballet class because her tights dug into her waist. At age 13, she writes, “my body had stretched and thinned,” and her teacher said to her, “You finally look like a dancer.” You might think that would be enough to convince her that such intolerable pressures – which pervade not only the ballet studio but the wider societies of many countries across the globe – are unconscionable and that something is wrong with the perpetrators of those pressures, not with those who are made to feel horribly inadequate and even to hate themselves.

Sadly, Covalucci reports that, after she began feeling better about her body thanks to being in a relationship with a man who treated her well – “Another person’s comfort with you can make you forget your discomfort with yourself,” she says – her therapist announced that she had an “eating disorder.” The result of that diagnosis was despair: “That’s when I really plummeted…. I spent mornings on the floor in a corner…, wailing because I couldn’t speak in complete sentences anymore and my brain, my beautiful, Harvard-trained brain wouldn’t work right.” As psychologist Michael Cornwall has written, assigning someone a psychiatric diagnosis is the “infliction of what amounts to a medical curse.”

Covalucci writes that eventually, she got better, and although she started taking psychiatric drugs that she says helped her, it was the ongoing love and respect of her partner that made a huge difference. (She later mentions Prozac, which often causes weight gain, and reports that she has become “fat” and is trying to have a positive attitude about that.) Even when at one point her partner mentions that she has gained weight, because of his loving attitude toward her, “The words lost their venom coming from him.” What would have helped, she says, is if her therapist had not told her she had an eating disorder, thus making it seem like she was “mentally ill,” that there was some kind of internal, individual difficulty she had rather than that she was responding to terrible pressures from her ballet teacher and society in general.

Given that the societal factors leading girls and women to panic about their weight are crystal clear, why didn’t her therapist address that with her instead of doing the most harmful thing, classifying her as mentally ill? That, too, would have been helpful, as the work of Prof. Carla Rice, former director of the Body Image Project at Women’s College Hospital in Toronto, showed decades ago. Once girls and women come to understand that they have been acting out impossibly strict societal standards with regard to eating and that their often distorted images of how they look have resulted from those standards, it is easier for them to begin to challenge them, keeping them in acutely conscious view, and to find other ways to feel good about themselves.

Indeed, why is it that so many people, even some astute critics of the traditional mental health system who are happy to challenge the pathologizing of emotional distress generally, cling uncritically to the term and concept of “eating disorders”? We come across it all the time and are genuinely confused and frustrated.

A Critical Omission

Those who challenge psychiatric diagnoses overall usually do so because on the whole they lack scientific foundation and certainly lack scientific validity, and they are in fact constructs invented by committees of people with vested interests!  Unlike physical illnesses such as diabetes and cancer, there are not, never have been, and are never likely to be objective tests for the so-called psychiatric illnesses. Critics of psychiatric diagnoses generally readily acknowledge that, for instance, “Borderline Personality Disorder,” “Schizophrenia,” and “Attention Deficit Hyperactivity Disorder” are constructs without biological basis and have been invented and promoted by a collective of powerful people with questionable objectives that are mainly concerned with increasing their profits, power, and territory.

It is alarming that too often, “eating disorders” diagnoses have been left out of the critical dialogue, leading to a bizarre situation in which almost every class of psychiatric “disorder” is challenged except this one. Why is it alarming? Why indeed would the pathologizing of emotional distress that involves food, eating, and body image be any more acceptable than the pathologizing of emotional distress that gives rise to obsessive thinking, dissociative experiences, or suicidal thoughts and actions? The concept of “eating disorders” is just as dubious as all of the other so-called “disorders.”  It is just as much a construct, and it is no more justified to call it “pathological” than, for instance, good old “PTSD.”

Traditional mental health professionals have capitalized in many ways on pathologizing socially created problems, and the “eating disorders” concept does this especially blatantly, given the well-documented ways that patriarchal society puts intolerable pressure on girls and women to believe they can never be too thin, persuading them that if they weigh “too much,” they will be unattractive to and devalued by men specifically and by society generally. In the process, it has become unusual for girls and women to be comfortable with their bodies, even when they become dangerously thin.

So why do some people who otherwise challenge “mental disorders” claim that the label “eating disorders” is legitimate and must be retained? One argument is that “It’s a biological problem, fundamentally physiological!” But the fact that depriving oneself of or bingeing on food has physical consequences no more justifies calling such behavior psychiatrically disordered than it would justify creating the concept “sprained ankle disorder.”

Like most people who take comfort in being psychiatrically labeled, some women and men may suppose that the therapist gave them a label because the therapist believes they are suffering. But that validation could be achieved by the statement, “I believe you are suffering,” which would not add to their burden by conveying the notion that they are also “sick.”

Besides masking the powerful social factors causing eating problems, to diagnose someone with an eating “disorder” is to make it extremely likely that they will be told something is wrong with their brain and that they need psychiatric drugs. Also, because severe restriction of food can have, at worst, fatal effects, caring family members may understandably agree to have the diagnosed person hospitalized, and sometimes even ask for this. But once hospitalized, in far too many cases, the person is increasingly medicated and stripped of their sense of agency.

Case Study

Consider the not unusual case of a teenage girl who had starved herself in reaction to her parents’ ignoring her pleas that they get a divorce because she could not bear their constant fighting and her father’s demeaning of her mother. Her parents resisted, though both of them longed to be out of the marriage, instead of staying together “for the daughter’s sake.” Talk about turning her reality upside down! When she was hospitalized in a psychiatric ward, her therapist advised her parents to forbid her to participate in the extracurricular activities she adored, where her immersion in the arts and her warm friendships were important in giving her strength to endure her difficult home life.

Allowing her to go home on a brief visit, the therapist also told the parents, “If you put 15 grapes on her plate, you have to make her eat all 15 grapes.” Thus, she was deprived of her sources of emotional sanctuary and infantilized, just as her parents’ and the doctor’s pathologizing of her as the source of the problem involved a stunning lack of respect and regard for the suffering caused by her home situation. And all the while, no one addressed the forces that led to her using starvation as a coping mechanism: her father’s demeaning views of real women and society’s message that the route to happiness and regard is through weight loss. Many unhappy women go on strict diets when they feel that important parts of their lives are beyond their control, but dieting is something they can control.

What would likely have helped that young woman would have been if first her parents and therapists had really listened to the pain that her parents’ awful relationship and her father’s demeaning view of women were causing her, and then had worked with her to find ways to reduce that pain. Both parents could have considered her needs rather than the abstract principle that even a terrible marriage should continue because it is better for the child than a divorce. The psychiatrist could also have helped the daughter to spend more time and energy in rewarding activities like her choir practice rather than forbidding them unless she ate what the therapist considered to be “enough.” He could also have helped her find ways to gain a sense of agency, given how helpless she was feeling, living with parents who were miserable and a father who demeaned women. And he could have helped her find ways to earn friendship, love, and respect other than by trying to become impossibly thin.

A New Perspective

The Power Threat Meaning Framework for considering emotional suffering could offer an infinitely more hopeful and respectful way of responding to eating distress than the traditional illness narrative imposed by psychiatry.  Lucy Johnstone, lead author of the article “The Power Threat Meaning Framework: An Alternative Nondiagnostic Conceptual System” published in the Journal of Humanistic Psychology, includes this advice:

“The Power Threat Meaning Framework can be used as a way of helping people to create more hopeful narratives or stories about their lives and the difficulties they have faced or are still facing, instead of seeing themselves as blameworthy, weak, deficient or ‘mentally ill’.”

This framework is a way to understand that “what may be called psychiatric symptoms are understandable responses to often very adverse environments and that these responses, both evolved and socially influenced, serve protective functions and demonstrate the human capacity for meaning-making and agency.” The adverse environments of the woman and the girl described above were clear and starving themselves was in both cases a way to try to take some control over how people evaluated and treated them. So helping them to understand that the adverse factors in their environment were unreasonable, inhumane, and harmful; to consider other ways to think about themselves; and to find different, life-enhancing, life-enriching, self-respecting, safe ways to feel a sense of belonging, being loved, and caring for themselves would have been natural outgrowths of a Power Threat Meaning approach to so-called eating disorders.

The Power Threat Meaning Framework would suggest that eating problems should be understood not as a symptom of an illness but as a reaction to difficult experiences, as a threat response, a way of surviving the intolerable, that will on every level make sense. The Framework is ultimately about the process of that sense being made, and surely few would disagree that there are always reasons, always stories behind every type of eating problem.

We both remember too many reasons and stories, just as we remember too many women who we’ve come across over the years who had internalized the belief that they had/have an “eating disorder.”  Just like any other psychiatric diagnosis, it has all too often robbed them of their power, taken away their agency, stolen their hope. The diagnosis of “eating disorder” in all its forms is as much a curse of psychiatry as any of its numerous others. Isn’t it time we called it that?

Update February 26, 2020: When we wrote this essay, some of what we wrote referred to social pressures on girls and women to be thin in order that males would find them attractive, and race/ethnicity and sexual orientation were not mentioned. We want to add that of course, there also are social pressures on girls and women to be thought by other girls and women to be “thin enough to be attractive,” and that can apply regardless of their sexual orientation. For some girls and women, if they don’t conform to heteronormativity or to what is considered traditionally “feminine,” their divergence inclines them to be more resistant to those social pressures, but of course that is not always true.

With regard to racial/ethnic factors, for a long time it has been assumed that Black women and girls were less likely to have eating problems and that this was due to cultural/environmental differences. But it is dangerously mistaken to assume that the pressures to be thin do not affect those who are Black, as reflected in the recent New York Times essay, “Why A Black Girl Might Want To Shrink.”

Finally, we did not mention men and boys who have eating problems, because they are less likely to have them, and it has long been known, for example, that men classified as obese and old are less likely to be considered undesirable than women classified as obese and old; but some men and boys of course also have eating problems and also develop distorted images of their bodies, what they think they should look like and what they think they do look like, because of pressures on males to have certain patterns and degrees of muscle development, for instance.



Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. “The Power Threat Meaning Framework for considering emotional suffering could offer an infinitely more hopeful and respectful way of responding to eating distress than the traditional illness narrative imposed by psychiatry.”

    If someone was selling a product, and stated it was (possibly) “infinitely” better than the competition, what would your first reaction (thought) be?

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  2. “The diagnosis of ‘eating disorder’ in all its forms is as much a curse of psychiatry as any of its numerous others,” I agree. As a matter of fact, the concept of eating disorders is a social construct that was created by Western civilization/psychiatry, and exported to the East.


    Years ago, I watched a very informative documentary about how the construct of eating disorders was exported from the West, to eastern nations, but I can’t find it right now.

    Nonetheless, you are absolutely correct, like all the DSM disorders, it’s paternalistic “bullish-t.” The magnitude of the harms being done, by the psychiatric/psychological industries, to Western civilization are absolutely staggering.

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    • Then again, much of the unhealthy standard Western diet of chemical-saturated monoculture and industrially-processed foods was also exported to the East and elsewhere in the world. Maybe people have unhealthy eating patterns and unhealthy psychological patterns partly because they are part of an unhealthy food system that creates havoc in the body, including in the gut-brain system, nervous system, hormone system, etc. There is a tremendous amount of research showing the connection between diet, nutrition, neurocognitive development, and mental health.

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  3. Naturally, Watson & Caplan on their own cut through the tangled web of academic distortion, and together make a concise point out of what is (surprisingly to some, I’m sure,) really a very concise point: harmful and unusual eating habits are not a pathology, and treating them as such exacerbates existing hierarchies.

    Reading this has given me A GREAT DEAL of comfort. I can feel viscerally that I am believed – after way too many “I think you have an eating disorder”s, finally some very intelligent people seem to be looking right at me and admitting that the pressures of an increasingly dystopian society are real.

    The example above is sad and perfectly expressive. There are so many more out there – if anyone doubts the validity of psychiatric language & labeling, they must denounce the eating disorder label(s) at least as much as they do the rest of the DSM.

    My personal 2 cents for anyone who needs another example: I do intermittent fasting as much as hormonal balance allows it out of my 26 day cycle. It keeps the 50lb weight gain from olanzapine (I quit over a year ago) off, and keeps my insulin sensitivity healthy. It’s helping me slowly shed loose skin. I dont eat processed food or animal products. Even I can admit, that all of my eating habits are driven by fear; of poisoning (ingesting something that causes akathisia); of brain fog (high blood sugar); of vulnerability (the rest that follows food); of contamination (the men who have inserted fluids into me that made me sick); and the craving for healing (like the extended fasting that finally helped me reverse the effects of PAWS from lamictal withdrawal). Plus, being thin grants me an unusual power over men and women alike. And, I’m saving money as veggies are cheap. The hair loss, weight loss, and fertility disruptions have been worth it, if a sacrifice I would rather not feel I have to make.

    The threat is foreign, unsafe substances I’ve been tricked into consuming. Controlling what goes into me is the power I’ve taken back. Having a way to guard myself, and a structure to rely on to do so, makes sense – there is meaning that I CAN understand here, as opposed to the non-sensical loop of gaslighting diagnosis & painful medication.

    If we can structurally begin to address the drugs, the coercion, the economic & sexual hierarchies, and the male violence, my own “eating disorder” would not be the only one to begin to resolve.

    Thank you Paula & Jo for being experts with broad perspective – a double rarity these days, as far as I’ve seen.

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  4. I appreciate this piece more than you know. My eating troubles started after and as a reaction to abuse. I was forced to have contact, knowingly, with my abusers wife for years, as she was my aunt. The effects the family’s reaction to my disclosure at the age of 12 had on me was nothing short of soul destroying. For over 2 decades I was force drugged, restrained, nose broken by a too large nasal gastric feeding tube forced upon my body, injected, imprisoned and electrocuted. Is it any wonder that meeting my bodies needs is still a struggle? I was taught by well over 100 people that my needs, my voice, didn’t matter. It took years to escape the clutches of the eating disorder treatment world. It took lying about taking meds as I was coming off them. And then when I found that my digestive system no longer worked as needed, I found an amazing GI doctor who ignored my label and saw me. He worked with me to get my body healthy in a safe and respectful way. He listened! I am dependent on a j tube for my nutrition, but this was my decision with an actual medical professional and was the last thing I did to get the system off my back. Once deemed SMI, I’m stuck in the oppressive state system, required to meet my handler 4 times a year, but I am drug free and away from those who told me my eating issues were the cause of ED(eating disorder). The notion of ED, as it is referred to “him” a lot in treatment, was crazy making, as though this other being was inside of me, waiting to take over at any moment.
    The treatment world also will state the statistics for death for eating disorders, the deadliest mental illness, often to scare you into treatment. What I experienced in treatment the last time when I refused meds, was watching women and girls being drugged to the point they couldn’t talk at night, being driven off every other day for “shock treatment ” since they ate better after. It all is done while telling you how much they care, and maybe some do. But their efforts haven’t saved several of my friends that I met throughout the years. 3 years ago I lost my prior roommate and soul sister. I will never forgive them for the drugging I saw them do to her….
    Healing for me is not a destination any longer, it is a daily endeavor that will most likely follow me all my life. Thank you for giving voice to this little known about or spoken about, world.

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    • Psmama,
      It is good to hear you refer to “the handler”. It really reduces their power, because how you see them is what they are. They are absolutely not “doctors”, or “caregivers”.
      We are the experts to what might be transpiring. They are supposed to be there to try and help people and labels have zilch to do with help. Labels hurt.
      Even “help” is all based on possibilities, no one holds the truth over anyone else, yet they might actually be able to help by giving people validation.
      And validation is not arrived at by once per week meetings.

      They are a shameful lot, carrying their own shame and disgust over to unsuspecting clients. They were never service providers, they had no service other than to deem something as abnormal. That was their sole function. What job is easier than to call someone a name? Even their psychotherapy was garbage because it was based on the premise of something being wrong which invaded the whole client…..and based on the premise that how THEY thought about it, or saw it, was the right way to see it.
      Since all that psychotherapy was a bomb, they tried chemicals, and since those don’t work, they try more.

      And here we are, hundreds of years later, with their grubby little fingers doling out to kids.

      “healing” is ongoing for everyone. Psychiatry as long as they practice their DSM, cannot heal. They cannot be use to themselves or others and it is the most difficult pill for them to swallow.

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    • It is gut wrenching to read of the horror story you endured Psmama. Years ago I used to think psychiatrists went into the field because they genuinely wanted to “help” people. But now they obviously see how much harm they are doing yet steadfastly cling to their labels and “treatments” so it is clear that not the case. In my situation I acquired a lot of legal evidence that proves my psychiatric nightmare was all about lies, collusion, spite, and punishment because I tried to make decisions that were logical and in my best interests after given a supposedly terminal ‘cancer’ diagnosis. An arrogant oncologist told me even I if took the standard 3 drug chemo cocktail I would not survive this supposedly raging cancer so he expected me to sign on to a clinical trial to add a 4th drug with ‘side’ effects of heart attack, stroke, intestinal tearing and vision loss. He would have been named as an ‘associate doctor’ on the trial and got paid very well for this. But when I read the info and declined the trial drug he blew up in anger and stormed out of the room. I never took the trial drug and it turned out the trial was halted early as there was too many fatal ‘side’ effects. Due to damaging effects of the standard cocktail I insisted on reducing the dosages and then quit it altogether. But unfortunately developing issues with insomnia was how they managed to lure me into the lion’s den of a cold-hearted psychiatrist to dog pile more lies and abuse on me.

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      • Rosalee, your replies the last couple days have been a validation shower over me. Thank you so much. Only the last 5 years have I begun to acknowledge the abuse for what it was. So I still find myself, at times, second guessing whether or not I actually deserved all of that. But deep down, I know i didn’t because I would never stand by and stay silent if i witnessed what happened to me, happening to another. And truth be told, I was the combative patient the last time I was in treatment several years ago because I called them out every time I witnessed abuse. They were telling patients that seroquel was an antianxiety!!!!!!!! Of course I told them all the truth and was taken aside for disrupting the process. I thought it was highly unethical that they were lying to patients about drugs.
        When I read your story it makes me so worried for what the medical field is becoming. It sickens me that this god minded doctor thought he had the right to play with your life at such a vulnerable time.

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        • No one “deserves” the crap that psychiatry doles out.
          Think about how their practice makes people feel on an emotional or physical level.
          Why do we hear that psychotherapy should be limited to a certain amount of time?
          Just long enough to get one’s brain even more entangled in the belief that psychiatry is legit, and that you are the issue.

          Our brains love to travel along the same path of thought and psychiatry loves to continue that thought by treating the brain’s thoughts. What better way to ensure more hard wiring. Then we can use chemicals to disturb patterns, but not actually target anything.
          Then we can treat the problems those chemicals made.

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          • sam plover, isn’t it crazy making that even away from them it still needs to be said that it wasn’t deserved? The psychiatric system knows how to make a person question everything about their judgment, especially when they get their claws on them in adolescence. And you are so right, it’s a constant hardwiring all while essentially punishing you because you aren’t “better yet”. There is no logic in the profession. But they are master manipulators, more than any person I met in any hospital or treatment center. Fool me once….never again.

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      • I am so glad psmama to hear that as validation is what we really need after enduring lies, abuse and gaslighting. I hear you as I too was frozen in shock for sometime after, not even able to begin to process what had all happened. (there is unfortunately much more to story) Yes it is very scary to realize how much vileness and corruption there is in the medical field in general and in addition to realize the ‘field’ of psychiatry that claims to “help” those who are suffering is a total scam and all about power, ego, control and coercion. This is why I am so grateful to MIA as the personal stories and very informative blogs by many professionals provide great validation to rebuke the gaslighting. MIA gives voice to the voiceless who were harmed and helps people realize they are not alone in enduring the nightmare of psychiatry. (kind of like someone blowing on your dying embers and bringing the fire back to life) Stay strong and thank you so much for your validation too!

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    • I believe you 100% Psmama, I am so sorry for all the abuse you endured, and I’m glad you escaped and are making a way out. The severe physical and psychological vulnerability of women in this situation cannot be understated. It’s like getting sucked into a death cult, that controls your basic needs as well as your psychological and physical safety and often chooses to harm all 3. It’s actually insane and evil. You were a whole person the entire time, and you deserve support to find peace and freedom from people who see you as that whole and valuable person who can and will heal.

      In the end, I believe loving and respectful social support is what provides what is necessary to begin to eat better again. I too, have seen people die after multiple rounds of rehab, inpatient, etc. Just gruesome abuse as well. Or just cycle in and out of the programs. Psychiatry simply does not understand “eating disorders”. Most people who work in the field never even went through it themselves. They just parrot what they read and drug people out of fear and control. There is only the whole person, not a disease. No ghost in the machine, just a human struggling.

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  5. There actually are eating problems that associate with psych symptoms, but they’re not psychiatric. They’re problems with fluctuating blood sugar and food sensitivities (addictive allergies), neither of which are “psychiatric” problems, though an inattentive shrink may think so if (s)he isn’t able to conduct a proper introductory interview and doesn’t ask about item like sweets’ consumption or favorite foods the interviewee craves and “has” to eat on a regular basis. If such things are true, it’s far better (though not as profitable) to make the proper referral, than to simply say “you have an eating disorder” and risk a session of fist-to-nose therapy with a knowledgeable client.

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    • Few people realize that the modern industrial diet is extremely unnatural with its high intake of starchy carbs and low intake of nutritious animal foods. Such a diet wasn’t even possible until quite recently.

      It was only in the 1800s that there were consistent high yields of grains and even then it was mostly fed to animals, not humans. Wheat and sugar are fairly recent introductions to the common diet, as they previously were only affordable and accessible to the wealthiest. Prior to the 1900s, Americans ate more meat than bread and, prior to the 1930s, more lard than seed oils.

      I’m constantly surprised, despite all the vast research, that most people still don’t realize the powerful impact diet and nutrition has over neurocognitive development and mental healthy. An unhealthy relationship to food is largely to do with what kinds of foods one is eating. Our entire industrial food system is built on and creates eating problems.

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    • The serious problem isn’t that we’ve pathologized eating problems for the minority diagnosed with a psychiatric disorder. Rather, much worse is that we’ve normalized the eating problems for the majority not diagnosed with anything. The standard American diet, including ‘plant-based’ versions, is a collective sickness.

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  6. “Schizophrenia” is a Serious, Long Term Disabling Disorder.

    “Schizophrenia” was a Serious Long Term Disabling Disorder for me for about 5 years, until I carefully stopped medical treatments “suitable ” for “Schizophrenia”.

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    • …”Borderline Personality Disorder,” “Schizophrenia,” and “Attention Deficit Hyperactivity Disorder”…”

      Every person I have ever met with “Borderline Personality Disorder,” has been a really decent person – with anything but a disorder.

      “Attention Deficit Hyperactivity Disorder” I’ve got a friend and he’s got 6 children and he maintains that even the Dalai Lama would find looking after 6 children difficult. Normal children have a lot of energy.

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  7. I found this aspect of my interrogation by my local Community Nurse verballer particularly interesting. His justification for incarceration and forced drugging being “not eating/sleeping”. Now of course as this ‘assessment’ (if you can call being tortured that) involved me being ‘set up’ he had some prior information provided by the person who had ‘spiked’ me and planted a knife and some cannabis for police to find. This was that I was not sleeping or eating for the past two days. The information was provided in the figurative sense, and not the literal.

    So the friendly verballer asks me about my eating, and I explain that I have not been eating as well as I usually do, but that if he could provide me with reference to any legislation which had passed without me knowing that required a certain caloric intake on a daily basis, I would ensure that I would fulfill my requirements for the State, and save him some time having police jump me in my bed. Of course he couldn’t provide such reference because I don’t believe it exists, however……. he uses the figurative language on his statutory declaration to mislead anyone reading his justification for incarceration and forced drugging because ‘disturbed eating and sleeping’ is hardly reasonable grounds for locking someone up, whereas NOT sleeping and eating may well be seen as being justification.

    Funny, maybe he could actually see the future because whilst two days of disturbed sleep and eating has now turned into nine years of not sleeping or eating properly. I say its because of the torture and kidnapping by public officers, but they seem to think its because of some illness I have, despite the psychiatrist who examined me that day stating emphatically that there was nothing wrong with me other than I was extremely angry about being snatched out of my bed (after being ‘spiked’ with benzos) and ‘verballed up’ by some fraud and slanderer who had lied to police about me being a ‘patient’ of his hospital to have them point weapons at me whilst he tortured me into a ‘confession’.

    I can’t see how without some form of legislation stating how much we are required to eat a person can be locked up for not eating. Its a rubber ruler used to justify arbitrary detentions otherwise. I mean personally I would have been more concerned about the Community Nurses alcoholism (drunk before 10 in the morning?) and the weight he had put on as a result of that, but he’s the one pointing the finger at people for police to brutalize for him before his interrogations. And I guess his ‘illness’ is a result of being a fraud and slanderer for the State soooo. Verballing being a form of ‘noble corruption’ the people who engage in this corrupt practice like to call it. Not so the people who spend years wrongly incarcerated and force drugged as a result of the practice, to them corrupt is enough. And of course the dead know only one thing, it is better to be living.
    Still, he’s getting the job done. And well I guess anyone who can have a young woman locked up in a mental institution (where it is highly likely she will be sexually assaulted. Our Minister tells us “you can’t listen to them they’re mental patients”) for not doing her dishes and make it sound ‘reasonable’ on a Statutory Declaration should be writing fiction novels, not swearing false court testimony on Mental Health Forms. A frustrated writer trying to get out there methinks.
    And he has the full support of his Operations Manger who is destroying anyone who has a valid complaint. She is the really nasty bit of work here, because it is my firm belief that she knowingly pushes people to violence and suicide with her gaslighting, and then has her colleagues justify their forced drugging and incarceration. Machiavelli would be proud.

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  8. Thank you for this important piece Dr. Caplan and Jo Watson. Yes, the label of “ED” should be tossed along with all the other DSM labels. Labelling someone with a ‘Eating Disorder” does what all other DSM labels do – places blame and finds fault with the person instead of their environment or adverse life events.

    “The Power Threat Meaning Framework can be used as a way of helping people to create more hopeful narratives or stories about their lives and the difficulties they have faced or are still facing, instead of seeing themselves as blameworthy, weak, deficient or ‘mentally ill’.”

    Yes, it is long overdue to stop the harm and cruelty of labelling people as broken, defective or somehow to blame because they endured or are still enduring difficult life circumstances beyond their control. Thank you for all your work and efforts in exposing the devastating impact of the invented DSM labels.

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  9. How is labeling moody teenagers “Bipolar” going to help them become emotionally stable adults?

    How is labeling a woman who has made poor relationship choices “Borderline Personality Disorder” supposed to help her make better decisions in the future?

    Don’t psychiatrists realize people can change, grow and improve?

    Unless you get “helped” by them so your brain quits forming normal synapses and everyone in your community shuns you thanks to the self-fulfilling prophecies these psychics/pseudo-scientists make all the time.

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  10. Thanks for bringing up this deeply important and under-addressed topic. And hope my rant-novel is okay. First of all, I’m annoyed by people who haven’t been labeled with this problem and haven’t been through the specific related psychiatric abuse, hijacking the comments section. The issue of saying “society” gives people eating disorders is also minimizing, the eating disorder industry is full of this crazy cult logic like “health at every size” and making the simplistic assumption that advertising and models gives people body image problems. As if women with eating problems are just vain and shallow.

    Like another commenter said; ABUSE/TRAUMA is most often the primary factor. Psychiatry and the ED industry profits from taking the focus off abusive families and onto some nebulous social pressure that supposedly activates a “disease”. Guess who pays the gigantic bills? Parents. So we can’t implicate them can we. So many women with eating problems are actually sexual assault victims and emotional or psychological abuse victims, trapped in a battle with food as a response to that trauma. Another factor is PORN and misogyny, the heterosexual dating world. Women’s day to day relationships matter so much more than a magazine. I am repeating myself but I hate the “media causes eating disorders” bullshit so much. It truly minimizes the interpersonal stress and pressure women deal with.

    What is most scandalous and evil, is that many of us with prior or current food difficulties (restricting, bingeing, purging, etc), started out as going through a rough patch that could have been short term, but by going to a rehab center or an “eating disorder specialist”, became actually worse long term and also got put on a bunch of pills in these centers. There is zero accountability for results in the eating disorder industry. Consider the way psychiatry’s pills actually make a depressed person more depressed and also induce the risk for suicide and sexual dysfunction etc.

    I believe the reason the eating disorder issue is silent is because frankly I have seen the horrors of women getting their minds scrambled by eating disorder professionals and eating disorder rehabs and becoming so afflicted by a worsened eating problem that they die or are otherwise so disabled that they cannot really put effort into much except getting through the day. Jeanene Harlick wrote about this, Laura Delano wrote about this, Julie Greene wrote about this. Julie is dead… why don’t y’all reach out to Jeanene and pay her real money to share her series exposing the eating disorder industry here? She is an amazing person and deserves money for her journalism. Her one MIA article was years and years ago. Did you all pay her for that? I hope so.

    I was also victimized, I was not eating enough and was groomed by an eating disorder therapist into going to a rehab residential program out of state and then also going to her own program close to home afterwards, I was put on zyprexa for social anxiety at the first program which was the beginning of disaster for me, and emotionally abused at the second program by the shrink and this therapist as well as chemically castrated which was totally ignored and treated as a joke (post SSRI sexual dysfunction). I have had severe post traumatic stress ever since (8 years).

    I obtained a copy of some of my records and I have evidence of the center owner woman’s unethical behavior as well as the damage she did to my mind. She’s a superstar hotshot therapist in the ED field and probably a multi millionaire, also psych faculty at the university. She wrote about me, “survivingthesystem’s suicidality is HALF ASSED” and “sexual dysfunction most likely repressed childhood trauma from mother” as well as described me as manipulative and other pseudoscientific abusive DARVO. Labeled me borderline personality after my life was destroyed by these centers, and used me quitting on her as evidence of “borderline splitting”. Fucking insane. Also explains why she sat there watching me sob about my sexual loss and I became a suicidal, bulimic cutter while she remained utterly blank and expressionless, smirking like it was funny. Wrote me up and disciplined me for falling into a zyprexa induced nap in the therapy groups. Said that i wasn’t trying hard enough to recover. When I quit this therapist, her employee the shrink who castrated me, leaned in and said “I think you quit because you’re avoiding hard work”. No, idiot, I’m trying not to die from neglect while I deteriorate. Same person openly accused my boyfriend of being bad at sex as the cause of my sensation problems. Then tried to turn around and call me bipolar. Nope. Just akathesic.

    Zero accountability for severe and worsening ED issues as well as PTSD and PSSD AFTER a million dollars billed of “treatment”. She also tried to chase me down after I quit on her, to lure me back. They don’t want their cash cows leaving. I was just a toy to her, I met 2 others with post traumatic stress due to this woman’s actions and they told me she’s a monster who belongs in jail and I agree based on their stories especially. Guess what her reward is? Fame, wealth, and glory being the owner of a treatment center. People worship her. She’s rolling in $1000 per day, per “patient”. I make a poverty wage due to being disabled and experience daily severe impairment. I qualify for food stamps. Before I went to the programs, I was mostly functional but simply not eating regularly due to stress and prior trauma. I had a boyfriend and a social life. That’s all mostly gone now.

    I am eating nowadays, but it took YEARS to deprogram myself of the brainwashing that these centers and specialists do. The mental trauma they cause truly creates a revolving door of customers for them. They act like “eating disorders” are a demon possession. Suddenly, nothing you do or say is your own, it’s “your eating disorder made you do this or that, your eating disorder is strong today”. The ED specialists groom you into dependency, whispering to you that they are the only ones who can save you, there is no real concept of friends and family being able to help. It’s like a ghost in the machine theory the same way that bogus chemical imbalances are blamed. Totally removes the agency and hope for sure.

    And again; all the weird brainwashing that being obese is okay and healthy and that “no foods are bad”. I was fed the standard American diet in rehab (dairy, carbs, sugar) and it makes anyone sick, we drank full sugar soda as a “fear food challenge”, there was no concept of medically therapeutic nutrition. Everyone was on a big cocktail of pills. Just my two cents and my story.

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    • Survivingthesystem,
      I truly am sorry for everyone who has ever been shat on by these losers.
      It is impossible for them to have even one iota of what is going on with others.
      THAT lack of insight on their part kills people or makes them nuts.
      I am not exactly sure why governments refuse to listen?
      There are ways to get them to pay attention, deaths of victims is not one of them.
      And no, the public reads these stories and change the subject, because they know,
      yet are SO scared that they have MI too.
      People hate to doubt themselves, so it’s best for them to pretend.

      Glad you were brave enough to FIRE your handlers. They remain lowly employees, not
      anyone’s authority.

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    • Survivingthesystem, chances are, we probably went to the same places. For me, 3 different centers, 6 times with being sent to the psych hospital in between, numerous times, due to the huge cocktails making me so suicidal yet a zombie, so shock treatment. It’s total medical neglect what they do. How do you justify drugging already malnourished bodies??? True medical issues are ignored or like you said, also blamed on ED and not real. Like pancreatitis, labs even confirming it, yet it was the “eating disorder talking ” because eating literally caused extreme pain. It took leaving AMA to get actual medical help and when leaving I was threatened with them getting a court order. Who you truly are ceases to exist in those places. It’s a mind field and the way they play patients on each other makes it hard to trust anyone there.
      Eating disorder treatment is a world of it’s own. I’m so sorry they hurt you too. I also struggle with severe post traumatic stress. And like you stated, I am one of those who is home all the time, unable to work, trying to do something meaningful everyday, even if it’s just giving extra attention to my pups.
      And thank you for your “novel”. You said everything I couldn’t because too much truth talking is a bit too overwhelming for my soul. Yet sometimes we gotta get it out too. The truth is worse than people want to believe.
      For me, models and tv had NOTHING to do with issues. Absolutely nothing! That drove me nuts too.

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  11. Survivingthesystem, so sorry to read of these horrible experiences you endured. The more stories I hear the more it seems many psychiatrists and these so-called ED specialists are sadistic. What kind of a human says anyone’s “suicidality is HALF ASSED”. I am glad you survived and escaped the abuse that is falsely promoted as “help”. Best wishes to you.

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  12. Why not mention how different diets have been shown to cause and alleviate various serious mental health conditions? Maybe eating disorders are real, even if the cause has been misattributed. Maybe it’s not about how someone eats but what they eat.

    The science points to this understanding being more widely applicable: mood disorders, schizophrenia, autism spectrum disorder, Alzheimer’s, etc. For centuries, experts have been linking mental health to physical health, often emphasizing diet.

    [I posted this comment once, but it had links in it and the comment disappeared. Apparently, links aren’t allowed to be posted. If you want to see the links, go to my WordPress blog Marmalade (benjamindavidsteele) and look for the following posts: “Physical Health, Mental Health”, “Ketogenic Diet and Neurocognitive Health”, The Ketogenic Miracle Cure”, “Diets and Systems”, “Moral Panic and Physical Degeneration”, and “The Agricultural Mind”.]

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    • I came across my comment again. I realize that, unless someone goes to my blog, they probably won’t know what I’m referring to. Most Americans have never been taught this info and so I can’t assume that anyone here has familiarity with it. Let me give an example to clarify (for more examples and info, go to my blog).

      In many chronic diseases inflammation is a central factor. This is seen in metabolic syndrome and autoimmune disorders, but it is likewise seen as brain inflammation in neurocognitive problems and psychiatric illness, from schizophrenia to mood disorders. Inflammation can be caused by lifestyle factors such as stress, inactivity and inadequate sleep, although some of the most important factors are related to diet and nutrition.

      For example, excess sugar or a generally high-carb diet along with industrial seed oils (i.e., the standard American diet; SAD) contribute to inflammation. And this SAD diet likewise contributes to metabolic syndrome which alters hormonal functioning which deals with appetite signalling and so can alter eating patterns and behaviors.

      This could get diagnosed as an eating disorder when, in reality, it is a dietary disorder. That is to say it’s a bad diet that is messing with the healthy functioning of the entire body. This can manifest in diverse symptoms that get diagnosed as a wide variety of conditions, even though the underlying causal factors might be the same or related.

      This is where something like functional medicine comes in. It looks at the body as a system but also at the totality of the individual’s lifestyle, relationships, and environment. Many systems in the body are interrelated. There are several connections between the gut and the brain, one of which is direct. Or consider insulin which is a hormone that is used as signalling both in the metabolic system and the immune system.

      I came to understand this from personal experience. I went on a very low-carb diet to lose some extra body weight. Unexpectedly, decades of severe depression disappeared and never returned. This is a common experience with a number of other psychiatric and neurocognitive ailments and issues. A lot of research has shown the mechanistic causes behind this.

      I don’t specifically know about eating disorders. But I’d be surprised if it had no relation whatsoever to diet and nutrition.

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    • Dr. Abram Hoffer cured “schizophrenics” with mega doses of B and C vitamins. Of course it wasn’t really “mental illness” they suffered from but a severe nutritional deficiency that caused hallucinations and other bizarre thoughts. Kind of like Pellagra.

      Dr. Hoffer should have come up with another word for it. But he actually helped people. Mom talked about taking me to his clinic in Canada back in the early nineties after my diagnosis. But it didn’t work out. Unbeknownst to us both, just going off the “meds” would have alleviated a lot of my problems. 20 20 hindsight. 🙁

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  13. There are eating issues attached to self perception and culture and there are other things. For me, I was near death several times because I was on 13 massive doses of pdrugs and I would FORGET to eat; then the iatrogenic effects of all those drugs coursing through my frail little 80 pound body would cause my mind to start looking askance at the entire process; thinking, perhaps, like a flower might think, these skinbags we have that require nearly constant processing of nutrients in quite an unsightly manner; watching people chewing, chewing, chewing with vast, arrogant amusement. Back in the day, I would become so weak & ill I would show up at ERs begging for treatment – after shoring me up with IV fluids, physical facilities kicked me to the curb for thinking incorrectly and psych facilities would not take on the liability. Its just one more example of how our rules, regulations & laws are all in place for the good of industry and not us; diagnosis primarily serves the reimbursement process and NOT US. But yeah, iatrogenic thinking, not on the list here. OH and hey admin: when you set this article up for printing, Jo’s name disappears ENTIRELY. Since you are a (fabulous, important, I love you) science-driven site I would imagine you might want to have software that shows multiple authors, yes?

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  14. Personally getting an ED diagnosis was helpful for me, although it was “Eating Disorder – Not Otherwise Specified” because apparently I didn’t fully meet the criteria for either anorexia or bulimia.

    The diagnosis gave me language to describe what I was experiencing and helped me to find a therapist. However, I completely understand the point that there is a broader social context for disordered eating behavior.

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    • One certainly does not need to go to a shrink for a “diagnosis”, nor a “misdiagnosis”.
      One already knows what one deals with, and there are a multitude of “help” out there and one being time, that might have the strength to carry people while they make discoveries.

      I already know I have a headache and don’t need it made official, nor do I need that official diagnosis to make me appear as a damaged individual, one that unwittingly has relinquished their standing in society.

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  15. Hello,

    As the author mentioned in the opening of this piece, I would like to clarify my experience with my eating disorder diagnosis. While I have no doubt that people come to great harm as the result of over-diagnosis, I do not believe that was the case in my own therapeutic experience. (To be clear, I am commenting only on my own life and mind.)

    My therapist gave me my eating disorder diagnosis after a years-long relationship, during which she came to understand that I thrive when I am faced with a concrete, well-defined “problem” to fix. I believe she used it as a tool to push me to take my behavior seriously. The diagnosis did not cause my despair. Instead, it allowed me to feel the despair I had been masking with my restriction: despair that the world was how it was, that my body didn’t conform to what I thought it should be, that I resorted to self-harm via food and exercise as a coping mechanism. Crucially, my therapist at the time did more than acknowledge that diet culture contributed to my eating disorder: she gave me ways to combat it and cope with it. (I don’t think “Write about deeply personal experiences in a national newspaper” was on the list, but speaking against diet culture this loudly was still oddly helpful!)

    Separately from my eating disorder, I have lived with depression for about a decade. I began taking antidepressants well before my eating issues intensified and found them enormously helpful. I found both my depression diagnosis and my eating disorder diagnosis empowering. Neither diagnosis makes me feel damaged or less-than.

    I would also like to correct the misinterpretation that it was my boyfriend’s love and acceptance of me that allowed me to recover. It was my own. He modeled his acceptance of me in parallel to the self-acceptance I desperately needed to develop.

    I share these things not to argue against the authors’ standpoint. I see from the other comments that many people identify with their argument. I only write to show that I am not the best example of it.

    Lastly, but very importantly, I want to thank the authors for reading my work and for their incredibly kind words toward me in this piece.

    All the best,

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