I don't have much time right now, but I couldn't let this one pass by without making immediate comment: a new decade-long study has just been released that tracked bulimic symptomatology among adolescent girls of varying racial and socioeconomic groups. And the results blow any notion that eating disorders are a rich, white girl's disease straight out of the water.

In a survey of 2300 girls from around the country, a team of researchers led by USC economist Michelle Goeree and economist John Ham of the University of Maryland, found that

"girls who are African American are 50 percent more likely than girls who are white to be bulimic, the researchers found, and girls from families in the lowest income bracket studied are 153 percent more likely to be bulimic than girls from the highest income bracket."

Furthermore, African American girls measured higher on a clinical index of bulimia severity than their white counterparts. Overall, 2.2% of the girls had clinical bulimia nervosa, equivalent to other population estimates.

Many measures of eating disorders depend on rates of diagnosis; however, given the secretive and shameful elements of eating disorders, combined with mental health stigma and the expense of care, the population of sufferers presenting for treatment is not necessarily the same as the total population of people suffering from bulimia. This research, which surveyed girls annually and asked questions relating to ED symptoms, body image, and depression, paints a much more heterogeneous picture of sufferers than those that appear in the popular media.

"The results illustrate the importance of having objective information on behavior rather than relying solely on data on diagnoses," Ham says.

According to Goeree, past research has over-relied on hospital admission data, creating a "sample selection bias" that overlooks those who exhibit bulimic behavior but do not receive — or have the means to receive — professional help.

"One explanation is straightforward: Girls with an eating disorder who are African American or come from low-income families are much less likely to be diagnosed. Who goes to the hospital? Those who have insurance. Who tends to have insurance? Wealthier, better-educated people," Goeree says, noting that another part of the difference may be due to parents' sensitivity to bulimic behaviors.

The findings also affect educational spending: "What we thought was that bulimia affects high income, high education white women. And, if that's the case, then you should try to tailor educational programs — because education is expensive — to the group that it will help the most," Goeree explains. "Now we're finding that it's really important to reach a completely different group than we thought."

And these results have implications for treatment.

"Based on their findings about the persistence of bulimic behavior and who is afflicted, the researchers argue that bulimia, which is currently classified as a disorder, would perhaps be more accurately described — and treated — as an addiction. As with drug and alcohol addictions, this would mean more federal, state and local treatment programs and fewer out-of-pocket insurance costs."

The summary didn't show what, if any, correlations were found between measures of depression, body image dissatisfaction, and bulimic behaviors, which was about the only thing missing. The main message? EDs don't discriminate.

With the never-ending dangers of obesity seemingly appearing around every corner, coupled with an encouragement of dieting and unrealistic looking celebrities, I'm almost astonished that anyone has an accurate view of what they look like anymore. For teens especially, when notions of self are forming yet still so fragile, self-perception can easily become distorted. And this body image distortion can be very dangerous.

A new study found that teens who think they're overweight (regardless of their actual weight) are much more likely to report suicidal behaviors than those teens who thought they were of normal weight. This effect was effectively limited to females, which doesn't really surprise me as women have always been first in line for diet/weight/health/appearance invectives from society at large.

The study revealed that body dissatisfaction had a strong impact on all suicidal behaviors for girls and was generally insignificant for males. For instance, any perception of being overweight by girls raised the probability of suicidal thoughts by 5.6 percent, the probability of a suicide attempts by 3.2 percent, and the probability of an injury causing suicide attempts by 0.6 percent...

"The prevalence of body dissatisfaction, among special populations of youths such as non-black girls, is significantly higher than the general youth population, even when the underlying weight is in a healthy range," Inas Rashad, an assistant professor of economics at Georgia State University, said. "Interventions that identify and assist these youths and educate them regarding a healthy body image will succeed in lowering suicide attempts."

My problem is with Rashad's statement that "the risk of suicide by adolescent females could potentially add about $280 to $350 million to the costs of adolescent obesity, which includes the direct cost of illnesses and associated health care and indirect costs such as productivity losses, reduced income and premature mortality" is wrong on so many levels. Adolescent obesity isn't the issue here, it's the distorted body image that is being fostered by obesity prevention programs.

I'm not going to hold anti-obesity programming solely responsible for distorted body image among teenagers- that's too simplistic, and body image issues have been around long before the health/weight zeitgeist of the previous several decades. But clearly, it's not helping. If you're going to promote healthy body image, telling a teen that she can only have good body image if she conforms to certain standards essentially defeats the purpose.

I do support programming that helps kids move around for fun and eat a wide array of foods, but let's take the "weight" aspect out of the equation, shall we? I don't think it's helping.

Adolescence pretty much sucks across the board. There's pretty much no getting around it. You're hormonal. You have zits. Your body is changing. The social pecking order is being cemented, and you become remarkably certain of where you are on it.

And there aren't very many places for fat kids. It was hard enough before, but with so much emphasis on the "obesity epidemic" now, fat is equated with ill health, sloth, and weakness. Which isn't good news.

A recent study in the Journal of Child Psychology and Psychiatry found "that traits such as obesity during adolescence that may increase the risk of attacks from peers can result in health and psychological struggles that remain through young adulthood." The authors studied not just bullying, but a wider phenomenon known as peer victimization.

[Researchers] examined peer victimization as a predictor of depression and body mass index in obese and non-obese adolescents. Adams explains that while peer victimization is comparable to bullying, bullying behavior typically involves one-on-one targeting while peer victimization can also entail victimization that can come from the peer group in general.

The study found that obese teens who were victimized by their peers were more likely to suffer from low self-esteem, low body acceptance, and depression.

The authors conclude:

"Victimization may not only reinforce the negative self-concepts that a risk factor for victimization, such as obesity, may cause, but a risk factor for victimization, such as obesity, will also make it more likely that the adolescent will be victimized indefinitely. In other words, the risk factors that strengthen the links in this pathway will also keep the pathway intact because it is also a risk factor for being victimized," Adams states in the report.

"Victimization may not only reinforce the negative self-concepts that a risk factor for victimization, such as obesity, may cause, but a risk factor for victimization, such as obesity, will also make it more likely that the adolescent will be victimized indefinitely. In other words, the risk factors that strengthen the links in this pathway will also keep the pathway intact because it is also a risk factor for being victimized," Adams states in the report.

To me, this seems to indicate that the health problems seemingly associated with obesity aren't the result of actually being fat. They also have a lot to do with the stress of feeling vulnerable, not accepted as a person, and ashamed of their weight.

Maybe by putting less emphasis on weight and more on health and happiness, the so-called obesity epidemic may just correct itself. And millions of teens may find adolescence just a tiny bit easier.