Anorexia vs. Bulimia vs. Binge Eating Disorder: Why Fight?

When our family is dealing with a horrible situation, it is natural to want others to understand OUR issue. I wish it didn't have to be a competition. We are all in this together.

Far too often the response to one person coming forward with an eating disorder story is "Yeah, well, why doesn't anyone care about..." This happens when anorexia is spotlighted because people feel bulimia is slighted. If male bulimia is discussed, people ask why not women with anorexia. A story about a very young sufferer and the question is "what about older patients?" And what about binge eating?

Shared Frustration with Public Information About Eating Disorders

I guess this comes out of a universal frustration with the state of public information about these illnesses. It is also, no doubt, a sign of the internal disagreements about the nature of eating disorders. Are they one problem with numerous ways of showing up? Are they several problems being stuck in the same category? Are the causes the same - and how about treatment? Are recovered anorexics like recovered bulimics? Are eating disorders a real identifiable illness or just part of the spectrum of normal human experience?

Calls to Action by Eating Disorder Leaders

One recent bit of information on this is well-explained in a paper out of Stanford about the infamous "Eating Disorders Not Otherwise Specified," or ED-NOS category in the American Psychiatric Association's diagnostic manual. Although clinicians have long known this and families see it all the time, this paper offered clarification that an ED-NOS diagnosis is no less serious than anorexia or bulimia, and no more helpful as a category.

A leader in the Binge Eating Disorder activism world, Chevese Turner, recently put out a call to the eating disorder world to stop excluding BED when listing or discussing eating disorders. But this presents a problem to a field that is already quite divided about what eating disorders are: is BED the same as anorexia and bulimia? While it is currently a footnote in the APA's manual, the next edition will reportedly give BED a place alongside anorexia and bulimia: is the eating disorders world going to embrace this?

Hang Together or Hang Separately

For myself, I'd like to see us do a better job of figuring out the nature of these conditions and letting the names sort themselves out later. I'd like to see the term "eating disorder" shelved in favor of a term that encompasses the constellation of mental symptoms that lead to and perpetuate the behaviors - not all of which involve eating. I doubt any of the current categories will have meaning when we've done that. But meanwhile, I think we are better off sticking together rather than fighting amongst ourselves. Alliances, not differences, make us effective.