Disability Activism & Advocacy

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Obesity should be seen as mental illness: expert   SHARON KIRKEY CanWest News Service Monday, September 10, 2007 Obesity is a mental illness, says a leading U.S. addictions expert, and extreme cases should be classified as a brain disorder. Nora Volkow, director of the U.S. National Institute on Drug Abuse, says brain circuits in obese people can become disrupted, producing an uncontrollable, compulsive and "pathologically intense" drive for food. People overeat and can't stop "even when they desire to do so," Volkow and Charles O'Brien, of the University of Pennsylvania, write in an editorial published this year in the American Journal of Psychiatry. Volkow says some forms of obesity should be included in the new edition of the Diagnostic and Statistical Manual of Mental Disorders, psychiatry's official "bible" of mental illness. Now in its fourth edition, the manual catalogues more than 300 conditions and their symptoms, from anti-social behaviour to voyeurism, and has been controversial since the first edition was published in 1952. Homosexuality was listed until 1974, under sociopathic personality disorders. The next issue of the dictionary of mental illness, used by doctors worldwide, is due in 2012. "Both food consumption and drug use are driven by their rewarding properties," Volkow and O'Brien write, floating the theory that overeaters are chasing the same "high" as a drug user. And they say that just as drug use destroys the ability to say no to drugs, overeating sugary and fatty foods makes people unable to exert self-control over their food intake. The result: "over time, massive weight gain." "I'm not referring to just anyone who is overweight," Volkow said. "It's the extreme cases in which the compulsion is so severe it basically disrupts their life, their professional lives, their health, their social interactions." She says the DSM recognizes eating disorders such as anorexia and bulimia but not obesity, "despite its devastating medical and psychological consequences." Recognizing obesity as a psychiatric illness would lead to new drugs targeting brain circuits that deal with motivation, drive and condition, Volkow says. Arya Sharma says some forms of obesity are clearly tightly linked to addictive behaviours. But, "I would definitely not say this is the majority of obese people," said Sharma, scientific director of the Canadian Obesity Network. "A lot of people say: 'For me, obesity has nothing to do with addiction; I have control over what I'm eating, I make proper choices and still I'm obese.' We know a lot of people like that." If some people are fat because they binge-eat, "then, of course, that needs to be characterized under the category of a mental disorder," Sharma said. And binge-eating ("eating, in a discrete period of time, e.g. within any two-hour period, an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances") is already listed in the DSM. Stuart Kirk, professor in the School of Public Affairs at UCLA and co-author of Making Us Crazy: DSM: The Psychiatric Bible and the Creation of Mental Disorders, says sweeping obesity, or some part of it, under the "psychiatric tent" is the latest attempt to pathologize human problems and expand the boundary of what constitutes a psychiatric disorder. © The Gazette (Montreal) 2007

Justin,

I agree with the comment made by STUART KIRK, ..".:sweeping obesity or some part of it, under the psychiatric tent is the latest attempt to pathologize human problems and expand the boundary of what constitutes a psychiatric disorder. "

In many states( and many countries as well ) all it takes is two people, not neccessarily doctors well trained in psychiatry, signing a paper stating that some individual 'SUFFERS FROM A MENTAL DISEASE OR DEFECT AND REPRESENTS A DANGER, EITHER TO THEMSELVES OR TO OTHER PEOPLE.

I`m heard from many sources that in the bad old days of the USSR that such laws provided the ruling regime with a convenient way of silencing dissenters

DO WE REALLY WANT THAT IN THE USA?

I sure don`t.                                                                                                  ollie

I think each case of obesity has its own merits as to whether it is a mental disorder, a physiological disorder, a genetic disorder, etc., etc., etc.

 

But as for your comments about the now defunct USSR and ruling regimes using psychiatry to politically isolate their enemies, that's precisely what's going on with the ruling heterosexual regimes in our country through the Christian fundamentalist movement.  They continue to brand us as "intrinsically evil", "unnatural", and all things "ungodly," because we're queers, even though the APA has already removed homosexuality from the DSM.

 

We live in far more repressive conditions here than meets the average American eye, don't we?    America the Beautiful?  -- if only we acknowledged all the ugliness and dirt that's always swept under the carpet in the name of patriotism and national appearances!  Not a good way to lead our lives. 

 

Honesty is the best policy -- foreign and domestic!  

 

Justin

morbid obesity when it s more than just "overweight is some sort of condition whether it's psychiatric or metabolic or by some other medical means created ........................ it is not natural to be or stay so big that your weight alone disables you from moderate functioning........ ............................ if you do not put a medical label on it you cannot get medical help .................. do you want that for others? ....................................................... perhaps you should ask people 300 over 1000 lbs what they think of having a medical diagnoses, a label that allows them to get medical care............................................... JASON - homosexuality was completely removed from the dsm manual. THE USA has NO "diagnoses" of homosexuality. The prejudice is purely religious and /or ignorance based.... gay and disability have the same relationship and straight and disability do. THEY can coexist, be coincidental, but ARE NOT RELATED.

morbid obesity also often also requires an enabler. When people are so big that they can not get out of a chair or bed except with help. Someone else who is acting against the persons best interests has to buy cook and deliver the excessive and bad choices in food to the obese person. WOULD YOU HELP DELIVER 3000 CALORIES A DAY OF JUNK FOOD TO SOMEONE +500 LBS?...................

Well. it seems to me that the words from a German Protestant minister regarding the horrendous things that took place in Germany from 1933 to 1945 have relevance.

He said: First they came for the homosexuals. I didn`t speak out  because I wasnt a homosexual.

Then they came for the communists and I didn`t speak out because I was not a communist.

Then they came for the Jews and I didn`t speak out because I was not a Jew.

Then they came for the trade unionist and I did not speak out because I was not a trade unionist.

Then they came for the Catholics and I did not speak out because I was not a Catholic.

When they finally came for ME, there was no one left to speak out.

 

Your point about judging individual cases of obesity is right on target.But sweeping obesity or sexual orientation or anything else into the category of a mental disorder can be used to create an atmosphere of fear and repression.

If you were to ask the average person about schizophrenia for example, I think they would be likely to say it means a person with a split personality and murderous tendancies. They might cite the movie PSYCHO as their source.

The word was first used by a European pshchiatrist to mean a personality that had been split( meaning seperated ) from REALITY. It was not meant to connote a person who had multiple personalities or criminal tendancies.

But a strictly medical definition of schizophrenia isn`t as good a selling point for trashy books, movies, magazines etc as a lot of mostly inaccurate but lurid details.

I think that a great many people wpuld be shocked to learn that a person with a severe mental illness is 6 times more likely to be a victim of a violent crime than to be the prepetrator of a violent crime. You can get more info on this by going to website of the National Alliance for the Mentally Ill.

But again, portraying mentally ill people( you can substitute any other group of people considered to be out of the main stream) as violent, sinful, hateful, evil and dangerous  and unknowable sells trashy entertainment  far better than giving a more realsitic portrayal.

Not matter who is the target of that kind of streotyping, it is still wrong and abhorrent. ollie

Well said Ollie......well said !..............peace and love......Norma