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We have a very tough case at the moment – a young woman with an eating disorder who needs long-term residential treatment, but her insurance company thinks two weeks is enough. The injustice of that decision is what we will address in our insurance appeal. What’s interesting to me, though, is the parallels between her life and mine. Her family looks perfect from the outside, but their body image issues clearly have contributed to her illness. She is deeply troubled – has been for at least 10 years. She abuses alcohol and drugs. She acts out in other ways, too. And she wishes she were dead. A feeling I know all too well.
I have been obese all of my life. I was 9 pounds 12 ounces the day I was born, and it’s all downhill from there. I’ve been to Dr. Atkins (yes, the Dr. Atkins), Weight Watchers, nutritionists, dieticians – the whole gambit. But never once has anybody suggested that I have an eating disorder.
With obesity being an epidemic, you’d think someone would have made the connection between obesity and eating disorders. Those of us who are seriously, chronically obese have an eating disorder, and we should be treated accordingly. The fundamental aspects of eating disorders – poor body image, an emotional tie to food – exist equally for people who are obese. My obesity is no less an eating disorder than anorexia and bulimia.
Once you make that connection, the way to treat obesity changes greatly. Individual and group therapy, even residential treatment that restructures one’s relationship to food, makes perfect sense. Just like a nutritionist at a residential treatment facility would eat meals with bulimic patients to teach them to eat more quickly, in a less restrictive way, the same could be done to teach an obese patient to eat more slowly, cut their food into smaller portions, and so on. Therapy that focuses on the causes of poor body image and relationship to food would help, as well. For someone like me, who has been obese since day one despite attempts to the contrary, it’s more than counting calories. It’s a complete revision of one’s relationship to food and the place of food in one’s emotional arsenal.
And just as anorexia and bulimia carry with them a code found in the Diagnosis and Statistical Manual of Mental Disorders, so, too, should obesity. And just as insurance companies cover treatment of anorexia and bulimia, so, too, should they cover treatment of obesity.
I never thought about my weight in this way before. I knew I had an emotional attachment to food, but I never thought of obesity as a mental illness. But it is. And perhaps if we treated it accordingly, more of us would be able to get the help we need.
Edited by Jody Smith
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