So as with gender identity, I go back and forth on whether I can apply labels like “mental illness” to eating disorders.
On the one hand, it can help to use this framing to explain that people with anorexia and bulimia are legitimately crazy – that their conceptions of their bodies and diets are not based on any kind of logic, that they really do hold irrational beliefs about food, eating, thinness, and starvation, and that they can’t simply be argued out of their disordered behavior.
But on the other hand, people with anorexia and bulimia are not psychotic. They’re not usually institutionalized. They can talk about having eating disorders without being stigmatized as dangerous – or irrational in general, incapable of making sense or telling the truth. People with anorexia and bulimia are not generally deprived of their freedom or treated as though they should not be in control of their own lives. Confessing to an eating disorder, current or past, does not make people anxious that you might relapse.
Eating disorders are sometimes praised, or at least conflated with extreme dieting practices that themselves are praised; women whose bodies are too thin are beautiful, and women who eat too little food are strong and tenacious.
And on the other hand, one gets into these thickets of really crazy, should you call yourself really crazy, do you have the right to refer to yourself as crazy, is it really as bad as being crazy, what if someone sees you referring to yourself as crazy? And maybe it counts as a mental illness if you are afraid to name it; maybe it counts as a mental illness if it is shameful.