To the Editor:
We would like to respond to the questions and comments in the op-ed by David Samra posted in TNH on 3/27/07, Notes from the Underground: War Against Eating Disorders?
We would first like to clarify the confusion about the obesity epidemic. Despite the fact the Americans are indeed gaining weight in large numbers, obesity has not been independently proven to be the cause of many health concerns or deaths. In fact, in the April 2005 issue of the Journal of the American Medical Association, overweight individuals were shown to have lower mortality rates than normal weight individuals, and that some types of body fat are actually protective against disease, especially for women and for those over 65. Only osteoarthritis and uterine cancer have been directly linked to excess body fat.
Furthermore, BMI (body mass index) is an arbitrary number that has been revised over the past decades with no scientific basis to predict weight status, health or mortality. BMI is not an accurate estimate of body fat (many athletes have BMI's over 30), nor does it account for waist circumference or belly fat, which has been correlated with health problems and increased risk of death. It is not until the BMI is over 35 (10 percent of the US population) that mortality rates increase (older people, however, have less mortality risk the higher their BMI). Therefore, in answer to the questions sited in the above article, yes, it is wrong to state overweight body images are unhealthy, and yes, the standards for body size are unrealistically too thin. It is also unhealthy to go to extremes to fit into an unscientific number range (BMI) that does not take into account genetics, fat distribution, fitness level, eating patterns and heart rate.
Yet, what the media and the diet industry would like us all to believe is that obesity is a killer, when in reality repeated attempts at dieting cause poor health (yo-yo dieting) and mortality. Focusing on the obesity epidemic fuels the $60 billion diet industry and contributes to unhealthy dieting, disordered eating and eating disorders. Studies show that 95 percent of diets fail and pose a risk for disordered eating and eating disorders.
The politics of eating disorders, including obesity, is about being a victim of this media hype and misguided politics that is oppressive, discriminating and biased as it stigmatizes individuals based on size and shape not unlike discrimination based on race, gender, sexual orientation and class. (Be it no surprise that minorities and the poor are shown to have the highest obesity rates). Being thin is equated with being healthy, attractive and successful, whereas being obese is associated with completely opposite characteristics.
Eating disorders encompass a continuum of disordered eating ranging from restrictive eating to overeating. Both are unhealthy eating behaviors. The One in Four student organization is not specific to any one type of eating disorder, nor is it a guise. UNH Health Services and One in Four are both highly committed to providing education and support for eating concerns to all (diverse) populations on campus. A seemingly worthwhile endeavor since 25 percent of UNH students (one in four) reported eating disorder symptoms and 50 percent (6000 students) believed weight or body shape influenced how they felt about themselves in a 2001 survey.
More important than debating the numbers, is the fact that eating disorders are the number one leading cause of death from a mental illness-a disease that consumes individuals with fear and preoccupation with food and eating in lieu of real life pursuits.
Health parameters can be improved by improving eating competence without weight loss. How much should a woman eat? A woman, like any individual, should eat according to her physical needs and cues (hunger and cravings) and not based on external influences such as thin images in the media or another's perspective of how she should look. Normal eating is about embracing all food, even chocolate, so that eating does not become deprivation driven. Normal eating is about trusting our bodies and being flexible with food choices.
How do men fit into this picture? Men are being diagnosed with disordered eating in increasing numbers. However, the media has different messages for men than for women. Women are consistently portrayed as thin, often abused, and subjected to male dominance and brutality. The message is that women are undervalued, small and should not take up much space. The message for men is to be big, muscular, strong, dominate and take up plenty of space. Perhaps, this is one reason for the confusion that disordered eating is only a feminist issue. If this were truly the case, then whose freedom is really in question? Would we then blame feminism for a man's (of any sexual orientation) eating concern?
Both One in Four and UNH Health Services oppose these images and value the inherent right of all individuals, regardless of race, gender, cultural, class or sexual orientation, to take care of their bodies in a positive and accepting manner. To this end, we offer support and education via our Web site at www.unh.edu/health-services or by calling the Office of Health Education and Promotion at 862-3823.
Maria Larkin, Nutrition Counselor Suzanne Sonneborn, Nutrition Educator Office of Health Education and Promotion UNH Health Services
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