The recently released DSM-5 (Diagnostic & Statistical Manual of Mental Disorders) adds the classification of “Binge Eating Disorder” to it’s compendium of mental health diseases, justifying it as a medical condition requiring treatment and covered through insurance. Yesterday the American Medical Association voted to designate  obesity as a disease, thereby labeling 78 million American adults and 12 million children with a medical condition requiring treatment.

These decisions are important and necessary as they increase treatment options and availability for patients. Prior to inclusion in the DSM-5, without a specific classification and criteria, insurance companies often resisted covering costs for treatment of binge eating. Along with the impact on treatment, our hope is that these changes will also reduce stigmatization,  further research, and increase awareness among healthcare providers.

Sadly, these decisions also reflect the consequences of living in an eating disordered culture. Highly accessible, inexpensive, nutritionally deficient, calorie dense foods have become standard fare in our American cuisine.  A recent Los Angeles Times article on founder of The Cheesecake Factory noted that one of their pasta dishes contains more than 3,000 calories – enough energy in one meal to fuel many of us for a day and a half. Additionally, cultural normalization of overeating, treating food as a reward and entertainment (entire television networks devoted to food), distorted portion sizes, and array of other culturally accepted attitudes and behaviors, all factor heavily in both binge eating and obesity.

Data on processed food production and pricing set alongside statistics for statistics on obesity indicate a correlation between increased availability of processed foods and increased obesity over the past thirty years. Correlation may not equal causation, but it’s certainly connected.

Why do we continue to focus on the problems resulting from an eating disordered culture while not addressing the systemic issues that may initiate and definitely contribute to both of these conditions?

Why does the medical community continue to use an inaccurate measure (body mass index) as it’s criteria for health?

Why doesn’t the government step in to address the huge role that the food industry plays in these problems?

When it comes to fixing the troubled relationships that people have with food and their bodies, we’ve put too much focus on the individual  and not enough effort into addressing the dysfunctions of systems that feed their diseases. My training as a systems thinker tells me that when one part of the family is symptomatic, we need to treat the whole family for sustainable change to occur. Pinning the problem on those suffering from the effects of a broken system (the “identified patient” in family systems terms) is not only ineffective, but leaves individuals bearing personal responsibility for problems much bigger than any one person.