Are We Trading Obesity for Anorexia? (Nov. 2, 2013)

For my November 2 article discussing the recent concerns that anti-obesity campaigns may be causing eating disorders, Are We Trading Obesity for Anorexia?, either click here or keep on readin’!

Are We Trading Obesity for Anorexia?

I was thrilled with the reaction to my last column, ‘BMI is DOA’, about the flaws of the BMI scale and the question of childhood obesity. I’m so glad to have struck a chord with so many people.

Since then, I’ve taken note of two remarkably similar (but equally surprising) news stories. Sandwiched between the weekend’s weather and the latest drama emerging from the Upper House, one headline stood out to me. “Do anti-obesity campaigns cause eating disorders?”

Woah. Now there is something to distract me from Pamela Wallin’s expense account. As a formerly obese child now managing anorexia, I was all ears. And an Oct. 21 article in The Wall Street Journal expressed many of the same fears as a Global News story last week. Broadly speaking, both asked if we are causing eating disorders and self esteem problems in children by promoting anti-obesity campaigns, alerting them to health risks associated with obesity, and education them about weight management.

The Global News story was primarily anecdotal, focusing on a little girl obsessed with her weight after overhearing her doctor inform her mother that she was clinically obese. This, of course, is terribly sad — though it represents the need for pediatricians to use discretion, not a systematic problem with the fight against obesity. The Wall Street Journal article, however, had a bit more teeth — statistics about the weight histories of eating disorder patients, interviews with advocates, and even the occasional scientific study.

So, should we can the anti-obesity efforts in an attempt to preserve the mental health and self-esteem of our youth?

A surprising number of people think exactly that. One of them is Joslyn Smith, a formerly obese child turned eating disorder suffer, who now works as an eating disorder advocate in Ithaca, N.Y. Prominently featured in the Wall Street Journal article, Smith spoke of her personal struggles and how she “learned that anything goes in order to lose weight.”

Leaving aside the fact that I’ve never seen any anti-obesity campaign informing children that “anything goes in order to lose weight,” much of the article was deeply troubling to me. Many of the claims were alarming and, at times, borderline offensive. My favourite? “For a subset of people like Ms. Smith, dieting can spiral out of control and lead to a severe eating disorder.”

Let’s hit this nail right on the head — an eating disorder is not a diet spun out of control. It’s a mental disorder. It’s a deep psychological problem. It requires, in most cases, years of treatment, doctor visits and medication. My anorexia most certainly isn’t unbridled enthusiasm for the Atkins Diet.

And yet the statistics are compelling. Forty-seven percent of those admitted to the eating disorder clinic at a Melbourne, Australia, hospital had a history of being overweight and the director of the University of Chicago Eating Disorders Clinic reports that one in 10 of his patients had been, at one point in their lives, overweight.

And yet, only 3% of the population suffers from eating disorders … while more than 60% are either overweight or obese. If the link is so self-evident, then why the discrepancy? Because “eating disorder” isn’t a synonym for “thin.” The 47% in Melbourne, the one in 10 in Chicago — they had unhealthy relationships with food long before the word “anorexia” was uttered in the doctor’s office. They didn’t develop an eating disorder as a reaction to being overweight; they had an eating disorder when they were overweight. Their weight was a symptom of their problems. They’re swinging on the pendulum of mental health disorders, food issues, and self esteem problems. Just like I did.

My relationship with food was just as unhealthy at my heaviest as it was at the peak of my eating disorder. Mentally, I was no healthier hiding boxes of cookies among my toys than I was vomiting blood in my university dorm. It’s the same song, just a different verse.

Now, please don’t get me wrong; this is not to say that all overweight people have an eating disorder. This isn’t to say that they all struggle mentally or are all masking deeper issues with a chocolate glaze. Some — in fact, most — simply eat too much and exercise too little. Lethargy and poor diet only combine for one result, and that result is the one targeted by anti-obesity campaigns.

Obesity is a symptom of many problems. While it may be a result of food issues and mental struggle, an anxiety disorder, or major depression, it also might be a result of eating hot dogs and playing video games. And while I can absolutely understand why a person with the former may take the anti-obesity message intended for the latter quite personally, I don’t think it serves as a justification for ending the fight against obesity. In large part, because that fight appears to be working.

For the first time, rates of obesity are actually decreasing among low-income children. For the first time, adult obesity rates have plateaued, not increased. All of the PSAs, the healthy food marketing, the photos of Michele Obama hoola-hooping — they seem to be paying off.

But Smith isn’t impressed.

“We need to focus on health and behaviour outcomes rather than weight outcomes,” she remarked. I’d agree with her if no health issues came along with that extra weight so many of us are carrying. I’d agree with her if anti-obesity campaigns were simply the creation of a vain society. But obesity, per se, isn’t the problem. The problem is everything that comes along with it — heart disease, diabetes, shortened life span, sky rocketing health care costs. It’s a package deal. You can’t take weight out of the obesity discussion, just to try to raise our collective self-esteem. We should teach our children about health and behaviour … and a large part of that is maintaining a healthy weight.

We can’t afford to sugarcoat it anymore.

Molly Daley is a nutritionist and runs the healthy cooking, fitness, and wellness website Diary of a Formerly Fat Girl. Find her at, or on Twitter, @DOAFFG .


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