飲食失序的秩序：生命歷程與日常生活

Abstract

本研究提出「飲食失序」一詞，作為eating disorders的新譯，藉此將中文原本的「飲食障礙症」、「飲食疾患」等帶有疾病意涵的譯名，改以因飲食實踐而受苦與受限的「生活狀態」作新的詮釋。此一狀態是光譜狀的，但為行文方便，我以「飲食失序者」指稱曾經或正在經歷飲食失序的人。 本研究從飲食失序者的個人經歷出發，探問：就飲食而言，「失序」的界線何在？其次，飲食失序者如何在飲食失序的狀態中組織生活？他們的生活經驗為何？最後則透過此一研究探討未來的研究方向。 資料蒐集方法包括深度訪談與次級資料分析。總共正式訪談22位我初步認定經歷過飲食失序的個人，並參考相關研究、新聞報導、飲食失序者在網路社群的自述等資料作為分析時的參考。 本研究發現，飲食失序者主要透過(1)「不成比例」的密集投入、(2)失控——無法按照意願進行的飲食、(3)污名行為、(4)對生理變化的感知四個面向，指認自己的失序狀態。再者，飲食失序狀態有三個主要特色：遵循特定飲食規則、過度飲食與催吐。這三個特色會隨著個人與時間而變化，造成不同程度的限制。並影響當事人的生命軌跡在這些限制下，飲食失序者必須不斷面對飲食秩序與一般生活秩序間的衝突，因而必須持續投入心力將飲食失序組裝入社會秩序之中。 本研究期望能使各界正視飲食失序的嚴重性，以協商有效的照護方式與照護資源。也期望透過檢視台灣社會中飲食秩序與社會互動秩序的交織，能為當前追求健康的潮流帶來反思。

This thesis introduces a new Chinese term 「飲食失序」 for referring to “eating disorders” in order to emphasise eating disorders as a state of life which suffers from, and is restricted by, certain practices of eating. Under the lens of medical sociology, this state occupies a form of spectrum, and people with eating disorders will develop different life trajectories on it. This thesis aims to achieve two objectives. Firstly, referring to the personal experiences of people with eating disorders, to locate on the spectrum for “disordered eating” where the somewhat fuzzy boundary exists between “disordered” and “regular” eating patterns. Secondly, to explore the ways in which people with eating disorders organise their lives whilst living in and around this boundary. The core concern of this thesis focuses on suffering in social contexts, analysing the data within the social factors connected with the interviewees. The data were collected through in-depth interviews from 22 people who were primarily identified by the author as experiencing eating disorders. Secondary data, including relevant research, news, and self-descriptions of eating-disorder experiences on social media, are used as references for the analysis. This thesis concludes that people with eating disorders usually identify their own state of disorder through four factors: (1) “disproportionately” concerned with eating; (2) loss of control (e.g. feeling compelled to eat, feeling unable to stop eating); (3) performance of stigmatized activities related to eating concerns (e.g. stealing food/money or stocking food), and (4) perception of the risks of physical damage related to disordered eating practices (e.g. palpitations). Furthermore, there are three key practices of eating disorders shaping the life trajectories of people with eating disorders: sticking with certain eating rules, overeating and self-induced vomiting. These three characteristics, changing with different individual and with time, construct restrictions to different degrees. Consequently, such restrictions force people with eating disorders to be confronted with the conflicts of their own eating rules, daily life and social roles, so that they must continuously endeavour to frame their disordered eating practice into the normal social order. This thesis provides Taiwanese society with an insight into the seriousness of eating disorders and the subjective experiences of people with eating disorders. Furthermore, to identify the shortfall of caring resources and understanding of people with eating disorders in Taiwan, and to point out possible directions for future research. Also, this thesis pays close attention to the “order” of eating interwoven with the social order in Taiwanese society, and hopefully evokes a reflection toward the current trend of “healthy living”.