Adjective does not necessarily = noun

Disabling, does not =disability. The adjective does not automatically become a noun.
For example, being poor could be seen as disabling, that's not enough to make it a disability. If you are going to use the economic system to decide this, don't complain about encroachment. Mental illness can become hugely disabling, to the point of almost being like the loss of a person.

But not all mental difficulty, neurosis, depression, anxiety, OCD is equally acute. A lot of it is situational. Dependent on adapting to your particular set of circumstances. Sometimes at particular periods of your life.

A dilemma, problem, conundrum or undesired effect, unsolved does not = a disease. Lack of solution, resolution does not mean an effect is a disease either.

So alcoholism and addiction are not diseases merely because no one has the means of predictably reversing them. Even when people's systems implode and they are held firmly in its grip, what your seeing is process, yes, it is like an illness, the person is likely to get very unwell. Again, calling that disease is an affectation. 

Ditto imperfection, perceived or real. 

Nor is drug dependence from your doctor any different or better morally speaking than addiction/dependence from an illegal source. The only differences are you don't break the law or get high on prescription (or aren't supposed to). Doesn't mean you are not an addict.

Nor is all shame about addiction 'ableism'. As with a lot of feelings of shame, it's root is in our sense of autonomy.

Saying, I have x neurosis i.e. anxiety and I take meds for it makes you a drug dependent, because no one should need medication to do things like calm down unless they've been through some seriously frightening conditions.

That doesn't make anyone a bad person, but it does mean they should be aware that this may play with their pride.

There's nothing wrong with deciding screw it, I can't deal with this right now, I'll take the pills, even if that =20 years. Because sometimes life is like that. The problem is when our vanity makes us invent, demand or go along with bullshit story-boarding of a poor me variety to try and cover up or turn off those feelings.

Everyone  bar none is showing their disgust for that particular habit, yes that includes those going in for it most noisily. What everyone's shouting at fat people reveals this starkly. The constant whining to fat people about "excuses" for instance is typical of letting this cat out of the bag. Insisting on these cover stories is the yielding to feelings of shame, not progressive categorisation and yielding to shame makes it your master. Increasing it deep down, whilst on the surface seeming to do the opposite.

iow, people's vanity is satisfied by claiming illness/disability/disease or whatever, but underneath that, they have shown they're ashamed to be dealing with it this way. That shame gets worse even through the relief of a little protection from the glare of scrutiny.

More importantly, it's not working. If it was people would not continually seek to re-connect with the feeling that this is a shameful falsehood, through fat people. That is their brain telling them they cannot outwit themselves this way.

It's not about any bootstrap bullshit, it's more that the urge to coin these things in these ways, is unexpectedly suppressive. That's why its coming up like this.

Instead of processing it and coming to terms with it not being the ideal solution, you've just suppressed that feeling and insisted nothing to see.

That would have been fine if folks could keep sch-tum. But as we see, they cannot.