Bone-thin or
overweight?
overweight?
Are you bone-thin or battling the bulge? Either extreme is unhealthy, and just a casual glance at the supermarket magazine rack or the diet section of the pharmacy aisle speaks volumes about the contradictory messages the media delivers as well as the body image crises, particularly eating disorders and obesity, that Americans – especially women – grapple to overcome.
Fat or skinny?
A trip to the local supermarket is all it takes to recognize two distinct, disparate trends in America’s body image. Various headlines at the checkout decry growing rates of anorexia, while others publicize the burgeoning field of bariatric surgery. The pharmacy shelves are stocked with products like Alli, designed to “block one-fourth of the fat you eat in each meal,” in order to aid desperate dieters, but the magazine rack prominently displays covers like US Weekly’s “Too Thin For TV,” denouncing skinny starlets.Overwhelming instances of weight extremes are so prevalent in America that the abundance of eating disorders and obesity are obvious even in our grocery stores. While both issues are worldwide epidemics, the US seems especially fixated on extreme ends of the weight continuum. How can two seemingly opposite body crises co-exist and infiltrate the American population so successfully?
The obesity figures
We hear a lot about obesity and its detrimental health effects, but where does America fit into this global affliction? The Centers for Disease Control and Prevention (CDC) consider an adult Body Mass Index (BMI) of 30 or higher to be obese. Though not an absolute indicator of body composition, the BMI provides an estimate of the average person’s amount of fat based on height and weight (weight (kg) / height (m)2).According to the most recent data from the World Health Organization (WHO), approximately 32 percent of the US population is obese (this doesn’t count those who are moderately overweight). Though this percentage pales in comparison to that in countries such as Nauru (which averages approximately 80 percent), America still ranks sixth on the list of obese nations, and its population is nearly 20,000 times that of the South Pacific island.
“People are eating high calorie, low nutrition food and moving around less. That’s the basic equation,” says Orin L. Bigman, MD, medical director of the Kaiser Permanente Eating Disorder Intensive Outpatient Program in Walnut Creek, CA. “In the last 30 or 40 years in this country, television has gotten bigger, fast food has gotten bigger. People have less time to cook.”
The dangers of obesity and surgical measures
The CDC points to obesity as the cause for numerous diseases and health conditions, including hypertension, osteoarthritis, dyslipidemia, type-2 diabetes, coronary heart disease, stroke, gallbladder disease, sleep apnea, gastroesophageal reflux disease, and some cancers.The increasing prevalence of obesity, along with its high mortality rate, has led to a boom in weight loss (bariatric) surgeries. The American Society for Bariatric Surgery (ASBS) states on its website, “This proven surgical approach, combined with the dismal failure of dieting, the marked improvement in quality of life and the quick recovery with minimally invasive techniques, has fueled the surge in the number of bariatric procedures performed annually over the last 10 years.”
The operation is designed to be either a malabsorptive procedure, which reduces the absorption of nutrients, a restrictive procedure, which decreases food intake, or a combination of both. An estimated 205,000 people opted for bariatric surgery in 2007, and an increasing number of obese adolescents are now undergoing procedures.
Types of disordered eating patterns
The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) only officially recognizes anorexia nervosa and bulimia nervosa as eating disorders (binge eating is listed in the appendix, and cases that do not meet full diagnostic criteria are considered “not otherwise specified” or NOS).Both disorders are defined by an extensive list of factors in the DSM, but anorexia is generally characterized by low body weight, body image distortion, and an obsessive fear of weight gain. Individuals with anorexia typically control body weight through food restriction, excessive exercise and other means.
Bulimia is generally distinguished by recurrent binge eating, followed by purging. Bulimia sufferers most often follow a binge with self-induced vomiting, but may also use fasting, laxatives, excessive exercise, etc. as methods of purging.
Eating disorders continue to be on the rise
Accurate eating disorders statistics can be hard to come by due to the high instances of unreported and undiagnosed cases. But according to the website for Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) , studies indicate that abnormal eating attitudes are on the rise in non-Western countries, presumably due to the increasing influence of Western media.Though America is not solely responsible for the glorification of slender bodies, little has been done in the US to counter the glamorous connotations of thinness. While fashion executives in Madrid and Milan passed rigorous bans to keep underweight models off the catwalks, organizers at New York Fashion Week refused to follow suit and enforce a minimum BMI requirement.
Eating disorders are not glamorous
The newly introduced minimum weight regulations were not unprompted. In 2006, two models died from eating disorders. In August, 22-year-old Uraguaian model Luisel Ramos suffered an anorexia-induced heart attack, and three months later, 21-year-old Brazilian model Ana Carolina Reston died of organ failure caused by anorexia and bulimia.Though the South American tragedies proved that the eating disorder epidemic spread far beyond US borders, the Council of Fashion Designers of America (CDFA) did not feel the need to impose a ban as other international fashion capitals did.
CDFA president, designer Diane von Furstenberg was quoted as saying, “There should be guidelines, and no enforcement.” In lieu of strict policies, the CDFA instead proposed a health initiative that included organizing seminars, banning models under 16 years old, and providing healthy food and water at photo shoots.
“I think if designers were interested in making clothes to fit everyone we wouldn't need to have bans – the clothes just wouldn't look as good on walking sticks,” says Los Angeles-based finance professional and fashion enthusiast Julia Kozlov. “But as long as this society values size 0 bodies, the people who can afford the clothes can also afford the regime necessary to get the size 0 bodies, and therefore will be the ones buying the fashions. [It’s a] vicious cycle if you ask me.”
Next page…How can America be so entrenched in two contrary weight disorders?
