Most people realize that eating disorders are unhealthy. Which makes it all the more ironic that many eating disorders begin with things done in the name of "health."
A blog post in Forbes magazine called What We're (Not) Eating addressed the growing trend of gluten-free diets being a cover for disordered eating. Writes Meghan Casserly:
Somehow though, despite the incredibly restrictive nature of the diet, the "G-Free" lifestyle is on the rise, even among those not formally diagnosed. According to marketing firm NPD's Dieting Monitor, nearly a quarter of American adults are working towards reducing or cutting gluten from their diets. It's all about cutting out a food group that the general public has come to see as bad. The gluten-free diet has become a sign of enlightened eating, an intellectual diet supported by a slew of studies and a passionate cadre of celebrity supporters.
...It's no wonder, then, that the young cheerleaders found the increasingly prevalent condition of gluten sensitivities the perfect cover for what turned out to be very real cases of anorexia. By the end of the school year, two out of the three girls were in treatment for eating disorders and the third was taken out of school by her parents.
...Stacey Rosenfeld, Ph.D, a psychologist who specializes in eating disorders is in the camp of those who believe that using medical or pseudo-medical reasons for restrictive diets is often a cover-up for disordered eating. "Nobody wants to be called out on an eating disorder or obsessive eating," she says, "so anything they can do to hide it, they will."
...Rosenfeld and Dorfman agree that setting rules around foods can start a vicious cycle in people prone to eating disorders, or those looking to lose an extreme amount of weight. The gluten-free lifestyle, while life-saving for the minority of Americans who suffer real consequences from grains, can be a slippery slope-or simply a means of denial-for some. According to Dorfman, the mentality is "restrict, restrict, restrict." "You set a rule that you're not going to eat dairy, maybe, and the amount of food you can eat becomes limited. Then maybe you're a vegan. And now you can be gluten intolerant."
What's left to eat?
Next to nothing. And for some, that may be exactly the point.
And so it is that the road to hell is paved with good intentions. Of course, people with eating disorders do have legitimate gluten intolerances and other food allergies. I'm not trying to imply that people with both issues are somehow fakes or frauds. They're not. But many also use things like vegetarianism and intolerances as a way to avoid eating.
It's also important to remember that people with eating disorders aren't using diagnoses of gluten intolerance simply as a way to be devious or solely further their weight loss goals. The real motivation, when you peel away talk of health and stomach pain, is fear. Fear of eating in general and gluten in particular. Fear of what will happen if they're in a social situation and actually have to eat. Fear of facing weight gain or even just weight maintenance. When a fear is that intense, you'll do or say anything to get a handle on the situation. The fact that the cover for your eating disorder is also socially acceptible is a really nice bonus.
In reality, the health kick fits the eating disorder mentality perfectly. For some reason, it seems to be important to some people with eating disorders that the food restriction is socially sanctioned. After all, we are people who generally place a premium on the opinions of others. So we use or concoct schemes by which others will give us a good, solid pat on the back while we starve, binge, and purge.
Doing something for reasons of health seems to make it above reproach. Coworkers or relatives might call you out if they think you're doing something extreme for vanity reasons. But health? And with doctor's orders? It's like a Get Out of Jail free card! It's a perfect excuse and short of reading someone's medical charts, absolutely unverifiable.
With society's intense focus on health, much of it related to concern over obesity, it's no wonder that some people with OCD tendencies get a little freaked out and take things to extremes. It's also no wonder that so few people question these diagnoses and so many doctors hand them out. Losing weight is generally seen as a good thing, so doctors feel less need to question a patient's motivations. Considering that bona fide cases of celiac disease and gluten intolerance are actually accompanied by weight loss, well, that's just icing on the (gluten-free) cake.
An article in Slate had an interesting series of graphs that charted the rise in diagnoses of "gluten intolerance" with the popularity of low-carb diets. The author also compared "lactose intolerance" with Mediterranean Diets. The graphs pretty much speak for themselves:
Daniel Engber, author of the Slate article, says this:
I'm not suggesting that anyone who avoids gluten is secretly trying to lose weight. The purpose of a gluten-free diet is, naturally, to feel better. But there's a complicated relationship between feeling good and eating less. When a restrictive diet becomes an end in itself, we call it an eating disorder; when it's motivated by health concerns, we call it a lifestyle. That's why Hasselbeck says going G-free will make you slim (a sign of wellness) rather than skinny (a symptom of anorexia). It might also explain the relationship between food sensitivities and fad diets: People who are intolerant of gluten or lactose get a free pass for self-denial.
With health as their cover, people with eating disorders can engage in behaviors with almost no one the wiser. And perhaps that free pass is the most coveted thing of all.