# "Disease" or Just A Bad Habit Out of Control?



## SeaBreeze (Mar 29, 2016)

These days I often hear advertisements or other things on TV and radio describing things like alcoholism or obesity as a "disease".  Growing up, I understood that things like this which affected people in a negative way were just bad habits that became out of control.  Of course if obesity is caused by something like a thyroid condition, it may be considered differently than someone who just has poor choices of the foods they eat or overeat due to emotional issues.

What are your thoughts?  Is alcoholism or obesity a disease or a bad habit?  Can a habit like smoking ever be considered a 'disease'?  I often wonder if these labels are created by the drug companies who profit immensely from selling pharmaceuticals to "cure" new 'diseases'.


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## Shalimar (Mar 29, 2016)

I believe that some people are genetically programmed to be alchoholics. Others can drink to excess, but never become addicted. Re obesity. My mother could eat anything, never gain an ounce.if I eat more than one meal a day, I gain weight 

rapidly. Poor eating habits, either by choice, or due to poverty, also  contribute heavily to obesity. Eating disorders are, in my opinion, a disease. Smoking, I am uncertain. Nicotine is more addictive than heroin, at what point does habit become a disease? From what I understand, social smoking, unlike social drinking is in the minority, due to tobacco 's addiction rate.


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## SeaBreeze (Mar 29, 2016)

Opinions on the subject from Psychology Today.  More here. 


Let's start with a short history.  In the bad old days, before the disease concept became widely popular (about 40 years ago), our society was even more prejudiced against people with addictions than it is now.  "Addicts" were seen as different and worse than "normal" folks.  They were thought to be lacking in ordinary discipline and morality, as self-centered and uncaring.  They were seen as people who were out for their own pleasure without regard for anyone else.  They were viewed as having deficiencies in character.

Then came the idea that addiction is a disease: a medical illness like tuberculosis, diabetes or Alzheimer's disease.  That meant that people with addictions weren't bad, they were sick.  In an instant this changed everything.  Public perceptions were less judgmental.  People were less critical of themselves.  Of course, it wasn't welcome to hear that you had a disease, but it was better than being seen as immoral and self-centered.  So, the disease concept was embraced by virtually everyone.  With all its benefits, it's no wonder this idea continues to attract powerful, emotional support.

Widespread enthusiasm for the disease model, however, has led to willingness to overlook the facts.  Addiction has very little in common with diseases.  It is a group of behaviors, not an illness on its own.  It cannot be explained by any disease process.  Perhaps worst of all, calling addiction a "disease" interferes with exploring or accepting new understandings of the nature of addiction.

This becomes clear if you compare addiction with true diseases.  In addiction there is no infectious agent (as in tuberculosis), no pathological biological process (as in diabetes), and no biologically degenerative condition (as in Alzheimer's disease). 

 The only "disease-like" aspect of addiction is that if people do not deal with it, their lives tend to get worse.  That's true of lots of things in life that are not diseases; it doesn't tell us anything about the nature of the problem.  (It's worthwhile to remember here that the current version of the disease concept, the "chronic brain disease" neurobiological idea, applies to rats but has been repeatedly shown to be inapplicable to humans.  Please see earlier posts in this blog or my book, _Breaking Addiction_, for a full discussion of the fallacy of this neurobiological disease model for addiction.)

As readers of this blog or my books knows, addictive acts occur when precipitated by emotionally significant events, they can be prevented by understanding what makes these events so emotionally important, and they can be replaced by other emotionally meaningful actions or even other psychological symptoms that are not addictions.  Addictive behavior is a readily understandable symptom, not a disease.

But if we are to scrap the disease concept and replace it with something valid, our new explanation must retain all the beneficial aspects of the old disease idea.  It must not allow moralizing or any other negative attributions to people suffering with addictions.  In fact, we'd hope an alternative explanation would have more value than the disease label, by giving people with addictions something the disease concept lacks: an understanding that is useful for treating the problem.

Knowing how addiction works psychologically meets these requirements.  Recognizing addiction to be just a common psychological symptom means it is very much in the mainstream of the human condition.   In fact, as I've described elsewhere, addiction is essentially the same as other compulsive behaviors like shopping, exercising, or even cleaning your house. 

 Of course, addiction usually causes much more serious problems.  But inside it is basically the same as these other common behaviors.  When addiction is properly understood to be a compulsive behavior like many others, it becomes impossible to justify moralizing about people who feel driven to perform addictive acts.  And because compulsive behaviors are so common, any idea that "addicts" are in some way sicker, lazier, more self-centered, or in any other way different from the rest of humanity becomes indefensible.

Seeing that addiction is just a compulsive symptom also meets our wish for a new explanation: unlike the "disease" idea, it actually helps people to get well.  As I've described in this blog and my books, when people can see exactly what is happening in their minds that leads to that urge to perform an addictive act, they can regularly learn to become its master, instead of the urge mastering them.

Despite all its past helpfulness, then, we are better off today without the disease idea of addiction.  For too long it has served as a kind of "black box" description that explains nothing, offers no help in treatment, and interferes with recognizing newer ways to understand and treat the problem.

And there is one more advantage.  If we can eliminate the empty "disease" label, then people who suffer with an addiction can finally stop thinking of themselves as "diseased."


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## fureverywhere (Mar 29, 2016)

Wooof, there is "addiction" and there are "bad habits". Nicotine and alcohol both spiral from bad habits to addiction equal to heroin. Everyone is different with alcohol. Some people can be fully functional for decades and be active drunks, likewise people can be active junkies. If the supply is there and they're functioning otherwise it can be easy to hide. Until the body starts to rebel.

Nicotine as been pointed out is more addictive than heroin. And it can take much longer for the body to rebel. I haven't had a cigarette in years and still dream smoking...it becomes like breathing really. That is an addiction. Not so much for someone who shovels cheeseburgers and wonders why they're 200 lbs. Unless it's binge eating, they really can't stop...then it's an eating disorder <<<hanging up my Chris Christie effigy>>>

My middle girl had all of the above plus she was a cutter. Is cutting an addiction? No it is not, it's a symptom of something haywire that needs serious addressing. So I guess that defines it. There are addictions, there are disorders, and there is bat crap crazy behaviors that signal someone needs intensive help.
<<<burning Christie effigy>>>


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## WhatInThe (Mar 29, 2016)

I think certain people are more susceptible to something like alcoholism but do they have a "disease" like cancer or the flu-no. I think words like therapy, rehab, disease rather than sober up are their just as much for the medical type 'treatment' and as not to discourage the alcoholic or friends. Also makes the massive mistake and poor decisions of voluntarily going the down the path of an alcoholic more palatable. Anything I've ever heard or read though says the alcoholic must really really want to sober up/change their ways. Trying to appease parents, spouses or judge/court is not true motivation.


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## fureverywhere (Mar 29, 2016)

With alcohol it has to come from within. No shame or intervention is going to help. I knew a guy who got so messed up that he was in his own truck and couldn't figure out how to open the door. A woman who lost her nursing license jacking the meds cabinet. Both continued to drink until that light bulb moment " Hey this has taken over".


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## tnthomas (Mar 29, 2016)

I think that a 'bad habit' is a "behaviorally based disease", the net effect is the negative health consequences, regardless of the label assigned.


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## Guitarist (Mar 29, 2016)

I think the debate as to whether or not addiction is a disease will probably go on for ages.  Some people are convinced it is a disease, others are just as firmly convinced it is not.  

I hear what you're saying about the TV commercials, SeaBreeze.  The drug companies seem bent on convincing viewers that every little condition is a DISEASE.  I saw the eyedrops commercial the other day, the one that says dry eyes is a disease.  I don't think it is, I think it's a condition.  I think these commercials are too quick to put on the label "disease" and make viewers think they're sick and need drugs.  

But I have no medical training, nor do I have any personal experience of addiction, so all I can express is my opinion.


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## Don M. (Mar 30, 2016)

There is a small percentage of the Obese population who have a medical condition...thyroid, or chromosome imbalance...that causes weight gain.  However, the vast majority just have poor eating and exercise habits.  I am not aware of any medical studies which claim that some bacteria or virus, etc., makes a person sit around with a beer and cigarette in their hand all day.  The vast majority of poor lifestyle choices are the result of bad decisions made by the individual.  Naturally, the drug companies, and our Health Care Industry both see a Golden Opportunity to make even more profits by joining the "Politically Correct" movement that refuses to criticize anyone, and instead just says its not their fault.


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## ossian (Mar 30, 2016)

I dont know with this one. I think it probably depends on whether you suffer from these conditions whether you consider them to be a disease or bad habit. Certainly both do have associated diseases when the conditions get out of control. Cirrhosis, diabetes, etc. 

There are also parallels with STDs here. But there are very clear differences in that STDs - while being largely self-inflicted - are nonetheless often bacteriological infections which we would normally always consider to be 'diseases'. 

I dont know. I think that I would consider alcoholism and obesity in themselves - where they are not caused by an organic failure or deficiency - to be conditions. However.......... that does not mean that I do not feel that these people deserve less support or understanding than anyone with any other disease or condition which requires medical intervention.


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## Kitties (Mar 30, 2016)

I've struggled with my weight all my life. Back to my childhood, food is how I comforted by self. My mother had severe emotional problems and could scream and rage for days on end. I'm 55 and if were so easy to lose weight I'd be thin years ago.

I comfort myself to this day. I have a co-worker who makes personal verbal attacks toward me. She did it again a few days ago. Plus another co-worker flipped on me because she was going to demonstrate to me how one nursing home patient had hit another (I was the only RN in the nursing home so it has to be reported to me) I stepped back told her not to touch me, she could demonstrate it on herself. She f---ing flipped out on me. Stated she couldn't deal with this &*%$ and went down the hall cursing. So appropriate. To calm her down I ended up doing half the paper work on the mess and calling the administrator to report the patient incident which we are required to do. She got out of work before me. I was so stressed out emotionally and physically by the whole day. I was beyond physically and emotionally exhausted when I got home. If it weren't for the cats, there are days I wouldn't know what to do.

When these things happen to me I have no one to talk to about it. I internalize everything. I just have the cats. And food. Yes, I'm fat but I can only be so fat and function on my feet all day as an RN. I've worked my ass off for 24 years trying to do this job right. More than younger, thinner people I've worked with. 

I do think addicts to drugs and alcohol get sympathy. I heard a major city radio talk show host once state you couldn't compare someone who has no control (talking about food) to someone who has a disease (talking about drugs and alcohol) And I think that sums up a lot of peoples attitudes.


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## Mrs. Robinson (Mar 30, 2016)

Interestingly,this has been a topic of conversation within our family circle the past few days. A friend,who was also my boss when I was doing property inspections,has been hospitalized in San Francisco for the past two weeks. On Monday morning,her mom told my daughter that Jen is dying. Her liver is shot and her kidneys have failed. She is on dialysis. As of Sunday night,they were talking of putting in a feeding tube and sending her home with Hospice. Her kids were taken there to say their goodbyes. All of this was due to alcoholism.

When I met Jen in 2007,she did not drink. At all. That same year,she had gastric bypass surgery and lost 100 pounds. She then started her property inspection company in 2008. As owner of this company,she was required to travel quite a bit and she and her office manager/best friend travelled all over the U.S constantly to different company conventions. That`s when she began to drink. Very shortly,she was drinking so heavily that her husband left her and got full custody of the kids-she was not even allowed to see them. She was put in jail countless times. Attempted suicide countless times. As of Monday morning,she did show some signs of recovery (I knew because she "Liked" a pic I posted on FB-I was shocked!) Anyway,my daughter talked to her mom and she told her that there was some improvement-probably due to the dialysis she was receiving. (My daughter went to SF to visit her today-I couldn`t go since I have my granddaughterand just text me that "Jen says hi!" so that`s good news) Anyway,the point of this whole story is that all of this has happened to Jen in less than 8 years!! From a teetotaler to a raging alcoholic in just so few years. Of course,her having had gastric bypass was a big risk factor for her. I`m pretty sure a "normal" person would not have gone down this quickly By the way,Jen`s mom just celebrated her 30th year of sobriety,so it`s in her genes. I say in her "genes" but who knows if that`s the case or if it`s just a learned behavior. Jen was 8 when her mom stopped drinking. Oh yes,I forgot to mention-Jen is only 38 years old. Way too young to die-especially from alcoholism. In less than 8 short years,alcohol took her family,her business (her mom owns the business now),most of her friends and now probably her life. If she does somehow surive,she will be on dialysis for the rest of her life. So sad. I truly do believe this is a disease-of sorts anyway. No one would allow alcohol to take all the things you love and cherish from you and not make ,at least an attempt,to stop drinking IMO.


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## Debby (Mar 30, 2016)

My husband is an alcoholic (sober now for 30 years- Wahoooo!) and we always warned our daughters, that they are predisposed to alcoholism.  On Don's side, both his mom and dad were likewise afflicted and his brother also ran into severe problems with drinking too much.   I can't remember how many times he promised to quit and didn't and didn't...he finally was able to because that was about the time that we joined the Adventist church and I truly think that it was the total change of lifestyle and friends that saved him.

Unless an alcoholic can change everything about their life, it is so hard to quit that for many only failure awaits.  Mrs. Robinson, your friend might have to do the dialysis forever, but if she got new friends and a new start in life, combined with the scare of almost dying from this, maybe, she'll be able to find the strength to do it.  I for one am sending 'good vibes'/prayers her way because this is a tough situation for her.


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## Debby (Mar 30, 2016)

Kitties said:


> I've struggled with my weight all my life. Back to my childhood, food is how I comforted by self. My mother had severe emotional problems and could scream and rage for days on end. I'm 55 and if were so easy to lose weight I'd be thin years ago.
> 
> I comfort myself to this day. I have a co-worker who makes personal verbal attacks toward me. She did it again a few days ago. Plus another co-worker flipped on me because she was going to demonstrate to me how one nursing home patient had hit another (I was the only RN in the nursing home so it has to be reported to me) I stepped back told her not to touch me, she could demonstrate it on herself. She f---ing flipped out on me. Stated she couldn't deal with this &*%$ and went down the hall cursing. So appropriate. To calm her down I ended up doing half the paper work on the mess and calling the administrator to report the patient incident which we are required to do. She got out of work before me. I was so stressed out emotionally and physically by the whole day. I was beyond physically and emotionally exhausted when I got home. If it weren't for the cats, there are days I wouldn't know what to do.
> 
> ...




That's so unfair that you are treated like that by your co-worker Kitties!  People can be so awful!

And it's unfair for people to assume that fat folks have no self control.  I'm sure there are lots of them, but seriously, it's about so much more these days.  Chemicals in our environment actually act like obesegens which simply put, means they affect our DNA and are changing us.  For example, that chemical BPA (makes water bottle plastic hard, lines the inside of cans of food, etc.) is an obesegen and if a pregnant woman for example, uses canned goods a lot, she's getting a dose of BPA with every meal.  Problem is that BPA(obesegens in general) is one of those chemicals that changes your DNA.

So think of this, if your mom was pregnant and using lots of hard plastics for drinking out of or food storage or canned goods, your developing DNA is evolving to where you hit a certain point and all of a sudden the weight starts coming on even though nothing else changed.  Thats why normal weight babies are more frequently turning into adults with weight problems/  And BPA is only one of the chemicals that does this.  I think flame retardants also are now considered obesegens.


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## 911 (Mar 30, 2016)

There are all kinds of addictions. Food addiction, drug addiction, smoking addiction, gaming addiction, online addiction and more. Those that may not want to admit that they are addicted to one of the above, may just say they have a habit because it sounds so much nicer than saying, "I am addicted to_____."


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## Ruthanne (Mar 30, 2016)

I think bad habits can lead to diseases or malfunctioning.  My eating problem, I believe, is a disease and I am totally out of control right now.  I also don't  want any advice on it because it seems to make me eat more.  That is a disease!!


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## Shalimar (Mar 30, 2016)

Many times I have comforted clients who have the misfortune to have inherited a tendency to gain weight. No one hears about those individuals who binge eat, yet gain little. It angers me to hear those not so affected, use body shaming words to blame 

them. I, myself, am restricted to one meal a day, purely as a result of my metabolism. Eating disorders are a disease, not a character defect. Obesity is not automatically a result of bad habits. If one is poor, unable to produce their own food, healthy 


eating is often put of reach, too expensive. A need to shame/blame others less fortunate than oneself, is a sign of a damaged 
personality. Any time we diagnose another, it always says more about us than the other person.


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