“ED” used to mean “Eating Disorder” 

What happened?
Eating Disorder Education (vol 2) October, 2007
(posted with kind permission from the publisher)

Chris Kraatz, Ph.D.

     Sexism in advertising is finally starting to receive some long overdue attention.  Recent events in the fashion industry involving the exclusion of models who are too thin from major fashion shows indicates, at the very least, a general awareness of the fact that portraying excessive thinness as desirable has a harmful effect on many women.  The underlying presence of sexism in medical research and the marketing of pharmaceutical products, however, has yet to be similarly acknowledged.

     Many people are probably under the impression that current trends in research and the pharmaceutical fruits of these labors are relatively free from the kind of market driven sexism which the fashion industry has finally begun to address.  This, however, is not the case.  And it is no small irony that this has come to light by way of a strange difficulty that has attached itself to the situation of some men, myself included. 

     While I’m certainly no fashion model, I do have a very long history of eating disorders, and we eating disordered men now find ourselves in a rather precarious situation.  We used to be able to discuss our eating disorders with a fairly relaxed and colloquial vocabulary, but now we have to be very specific indeed.  I’m careful in my conversations, for example, to tell people that I have bulimia, anorexia, and binge-eating disorder, and that I’m still struggling to keep my 8+ years of recovery.
     It’s not that people don’t believe that men have eating disorders.  In fact, since actor Dennis Quaid came out about his anorexia last spring, many people don’t seem all that surprised to find out about other similarly afflicted men.  So what’s the precarious situation, you ask?  Well, such specificity of discourse was not always a requirement in connection with eating disorders.  As recently as five years ago I could, for example, have simply told you that I have an ED.  Even if you weren’t familiar with the jargon of us eating disordered people, it wouldn’t have been difficult to find out exactly what I was referring to;  the topic of discussion would have been unambiguous – eating disorders.
     Slowly and almost imperceptibly, our vernacular abbreviation has been usurped.
The majority of people today upon hearing any reference to ED think only of erectile dysfunction.  Hence, the requirement of a more specific vocabulary arises in order to avoid a potentially awkward misunderstanding.  As a philosopher, I find such a complete change in the accepted meaning of a label (over such a relatively short period of time) to be a curiosity that wants an explanation.  What should we make of this new meaning of ED?

     The most obvious feature of this shift in the meaning of ED from eating disorder to erectile dysfunction is, of course, that the label which once applied mostly to women now applies exclusively to men.  And upon careful examination, it appears that this male orientation in our language is a symptomatic reflection of a much deeper and more serious form of sexism. 

     This deeply rooted sexism, which is only dimly suggested by our use of language, more openly betrays itself in our financial priorities.  The National Institute of Mental Health, for example, spends about $21 million per year on eating disorders research.   While this sounds like a large chunk of money, it is less than 2% of the NIMH annual research budget and it is also less money than what the NIMH spends on research for any other “mental illness.”  Not surprisingly, this meager research has produced few useful results; there is no standard accepted model for the treatment of any eating disorder, and there are no pharmaceutical products that have been found to provide effective relief for even a small percentage of those of us who suffer from these conditions.

     Compare this situation with the current research and treatment options available to men who have erectile dysfunction, and the absurd lack of balance stares you right in the face.  Despite the fact that many men are noted for thinking with their penises, the NIMH doesn’t consider erectile dysfunction a “mental illness.”  Not to worry, pharmaceutical companies have taken up this cause whole hog.  The research conducted by Pfizer and Lilly in the last five years alone, combined with the resultant media blitz on behalf of Viagra and Cialis runs into the hundreds of millions of dollars. 

     Our cultural trends in advertising have always offended my feminist sensibilities, but the situation that has resulted in the conscription of ED on behalf of erectile dysfunction really takes the cake.  Every year in the U.S. 17,000 anorexics (15,000 women and 2,000 men) die as a result of their eating disorder.  Bulimia and binge-eating disorder also claim a staggering number of lives annually, mostly female lives.  There are about 27 million
people in the U.S. currently struggling with a diagnosable eating disorder (mostly women), and eating disorders are in the top ten leading causes of death in the U.S. 

     By contrast, there are about 12 million men in the U.S. with erectile dysfunction, a condition which, even in its most virulent and yet flaccid manifestations, has not caused any deaths – unless, of course, the metaphorical “dying from embarrassment” counts – and I don’t think it does.
     Since our spending indicates our priorities, it would appear that a few guys not being able to get an erection is a national health crisis but thousands of women dying is no great cause for alarm.  If our national eating disorders epidemic were cause for alarm, wouldn’t we see some evidence of our concern reflected in current research and treatment options?  But there is precious little of this concern being demonstrated at the NIMH, the nation’s primary research facility for eating disorders.  Who says there's no sexism in medical research?
     ED meant eating disorder first.  And there are several important organizations who have taken up the task of addressing these problems and bringing eating disorders back into public awareness.  Nationally, the Eating Disorders Coalition is dedicated to advancing “the federal recognition of eating disorders as a public health priority.”  The Eating Disorders Coalition is available online: http://www.eatingdisorderscoalition.org/

     Here in Indiana, concerned citizens are encouraged to contact the Eating Disorders Task Force of Indiana, a professional organization also available online: http://www.edtfi.org/ 

     The Indiana Eating Disorders Coalition is also gaining in strength and numbers, and is more of a grass-roots organization of concerned people from all walks of life dedicated to raising awareness and bringing about change.  For more information about the Indiana Eating Disorders Coalition, contact Amy Kuehn at amster_71@comcast.net, or contact Chris Kraatz at ckraatz@iupui.edu.