Increase in obesity and eating disorders

You can hardly read a newspaper without hearing about the "obesity epidemic." And disordered eating also appears to be on the rise.

But a new study from Australia has shown that the combination of the two (obesity and eating disorder behaviors) is increasing faster then either obesity or disordered eating alone.

The study measured self-reported height and weight, as well as behaviors like restrictive eating/dieting, purging, and binge eating in two surveys- one from 2005 and one from 1995. The authors found that both obesity and disordered eating had increased independently of one another. But the largest increase was that combination of obesity and ED behaviors- a person in 2005 was 4.5 times more likely to have a BMI greater than 30 AND ED behaviors than one in 1995. Breaking the statistics down even further, one in five obese people had eating disordered behaviors. Binge eating was the most common behavior, but rates of purging and restricting weren't insignificant, either

Conclude the authors:

The reason for such a large increase in the number of obese people with ED behaviors in a relatively short time span of 10 years is unknown. In recent years, the obesity ‘‘epidemic’’ has received much attention in the media and from politicians, public health promotion, clinical health professionals, and others treating obesity. Perhaps these confronting, and at times alarmist, messages, have been conducive to increased levels of body dissatisfaction among obese individuals, and to a perception that weight loss at any cost is the best outcome. This might also account for the observed increase in the prevalence of binge eating and extreme weight control behaviors, as body image dissatisfaction is a risk factor for disordered eating.

It appears that the original "health" message in obesity prevention got lost in translation. Most people would say that forcing your weight below a BMI of 30 by throwing everything up is unhealthy (as much as they would congratulate you in the same breath). However, I don't think these "health advocates" realize how common, and how detrimental, these behaviors really are.

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8 comments:

Katy said...

Wow. I'm not surprised, somehow, but I hope this study will get publicity...it could be a HUGE myth-buster. It challenges public perception of what someone with an ED looks like as well as the idea that we absofreakinglutely have to berate obese people about losing weight "for their own good" and that there couldn't POSSIBLY be any negative consequences to all the omgFAT! hysteria.

I wonder, though, whether a lot of people in the medical community will see ED behaviors in obese individuals as problematic, ESPECIALLY if they result in weight loss. (After all, some of the diets docs advocate amount to ED or quasi-ED behavior...) I saw a doc once who told me my significant weight loss (from "overweight" to "normal" weight) was "great!" This was AFTER I told her I had lost it through pretty severe ED behavior & in a very short & clearly unhealthy time frame.

So there's quite a bit of medical loopy-ness out there, which might get in the way of people seeing how important this info is.

Still, the study ROCKS. (I mean, the results kinda suck, but the fact that it was done & published rocks.)

Carrie Arnold said...

Katy,

Sadly, I don't think this study will get much publicity. It's new, but it's also old enough that the "news peg" that editors and writers are looking for is pretty much gone. Also, it's not alarmist in any sort of way.

And you're right- I don't think people are going to see weight loss in someone classified as "obese" as unhealthy, even if it is.

Fiona Marcella said...

sadly you are so right Katy - even people who REALLY should know better seem to think that weight loss is the magic cure for everything from diabetes to the war in Iraq.
A family friend with a long history of psychiatric problems which have never been linked to her eating patterns but undoubtedly should be, recently lost over 28lb in a short while by using some very dangerous methods. She suffered some very worrying side effects and attended the doctor's surgery about them. As was still very large, having gained a lot of weight owing to both medication and binge eating all he said was "you need to lose weight" - grrrrrrr

Libby said...

Most people would say that forcing your weight below a BMI of 30 by throwing everything up is unhealthy (as much as they would congratulate you in the same breath)

Ohhhh yeah.... In 1993 and off and on through about 1999 I was a bona fide DSM-diagnosable anorexic, BMI and all. Come 2002 or so and with the help of tricyclic antidepressants and an endocrine disorder or two, I'd gained a lot of weight, pushing me to the clinically obese category (ha... I just mistyped that as "obsess"... Freudian? *grin*).

I relapsed in 2003... in 3 months I lost a disturbing amount of weight by swimming 10-15K/week and eating air and water. My doctor congratulated me. I was in total denial, and so the behavior continued. After all... my doctor said I was OK...

Thank heavens I had a therapist at the time who was more on top of things and saw my relapse happening... and guided me into some of the best treatment I've had yet.

This study? I totally believe it. I wish more people would see it and take it in and realize that weight loss at any cost is just plain dangerous.

(btw... I've since found an awesome doctor who really, truly "gets" it.)

Fiona Marcella said...

at least some sensible clinicians are on the case on this one http://www.timesonline.co.uk/tol/life_and_style/health/features/article5057229.ece?Submitted=true

Carrie Arnold said...

Marcella,

Yep- blogged it. ;)

Thanks for sharing, though- I don't like gems like this slipping me by!

Anonymous said...

This post hits very close to home. I think it is great how you consider all kinds of eating disorders here, even the non-stereotypical - you do a better job than most health professionals.

I have shown eating disordered behavior almost as long as I can remember - there were times when I could have been diagnosed with EDNOS (of the binge-eating kind). The biggest problem that I face as a fat person though is that I have hardly met anyone who truly gets the nature of my eating disordered behavior. Yes, I binge. But that's only half (or less than half) of the story. Maybe most importantly I am also a chronic dieter - I have lost significant amounts of weight many times (and regained it all), and I always ended up obsessing about and restricting food intake to a degree that was unhealthy. During one of those weight loss attempts I stopped having my period and experienced strong hairloss. Yet, no one was worried, least of all the health professionals that I saw.

It is frustrating. I want to normalize my eating behavior, but it is an ambiguous thing for me because I know that normalizing my eating will not get me down to or even close to what is considered a normal weight. There is a part of me that is not ready to give up dieting or restricting. It is the same part that makes it impossible to see myself in the mirror without feeling disgust. This part is supported by the attitudes of pretty much all health professionals I have ever met (with one notable exception) as well as of many of my friends and family members.

I believe that those people genuinely want to help, however, they often seem unwilling to listen. I have been dealing with some degree of disordered eating since I was eight or nine, I am also very self-reflective, and I happen to study a clinical psychology related subject. Yet there are very few people that take it seriously when I tell them that it is counterproductive to lecture me about my weight or to recommend yet another diet. If I lose weight this means for them that I am in recovery, no matter how I lose the weight, and no matter how much I obsess about it. It makes me tired.

I know that in the end I will have to find my own way out of this, but it really would be nice to have some support.

Carrie Arnold said...

Sannanina,

I just saw your response, but I want to tell you this: your weight doesn't determine whether or not you NEED and DESERVE help. You are suffering. Bingeing and starving SUCKS. I've been there. An eating disorder is hell.

There are many bloggers and many websites that can help you know you're not alone. Email me if you ever need extra support.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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