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The Edmonton Journal, January 22, 2004
Dangers of obesity often exaggerated
while
perils of dieting usually ignored.
The recent Sunday Reader feature
'The feud over fat acceptance' was timely material as January
is the month of diet and fitness advertising. Just as these
mini-sermons reach a crescendo it seems that many of our
resolutions fall by the wayside.
I im a local psychiatrist with special training in eating
disorders, and I frequently deal with the interface between
eating disorders and obesity. In 1992,1 founded the Eating
Disorder Education Organization (EDEO), due to the lack
of information and support available to my patients and
their friends and families. EDEO has brought many eating
disorder, obesity, and size acceptance experts to our region
with a recurrent message: we must encourage our patients
not in losing weight, but in improving their health, whatever
their size.
People may claim that they are dieting for health reasons,
but most have weight-loss goals that put their efforts clearly
in the cosmetic range. While very modest weight loss has
been shown to reduce the risks of obesity, most people want
to lose far more than the safe and sustainable 10 to 15
per cent.
We live in a society where many people will do anything
in the name of weight loss-risking jobs, relationships,
health and sanity if they believe it will help them reach
the "beauty ideal.' Extra pounds can put extra demands
on the body, but the risks of being overweight or obese
are often exaggerated. More importantiy, the risks of diet
behaviours are usually ignored.
Most people know that many fad diets are dangerous if followed
for extended periods, but some dieting practices are life-threatening
right from the beginning - eating disorders have the highest
mortality rate of any psychiatric diagnosis. Ironically,
none of these compensatory behaviours is guaranteed to cause
weight loss, and bulimic patients generally gain weight
from the binge/purge cycles. So dieting can lead to disordered
eating, and then to eating disorders.
These dieting practices must be safer than obesity! Sadly,
no. The risk to those who continue to battle what is certainly
a genetically predisposed condition, is the common path
of yo-yo dieting, or weight cycling. The vast majorit of
those who start their diets in January — or every
Monday morning — not only regain whatever pounds they
lose, but find a few extra pounds due to an ever more efficient
body. Particularly frightening is the prospect that the
most rapid weight loss (after water) is of lean body tissue,
but the weight regained is mostly as fat.
It has been stated that we have a better chance against
most types of cancer, than we have of beating obesity. Is
this the crux of the prejudice — people don't choose
to have cancer? But all the advertising we are exposed to
brings that same message — weight is something we
can change, if we buy the right products, if we just try
hard enough, if we choose to.
Nobody waiks into their doctor's office and asks for help
to grow a foot taller. Losing 50 or a hundred pounds may
be just as futile. Not that it hasn't ever happened,but
it is exceptional — and every one wants to be that
exception!
Please don't think that I am saying that weight loss is
hopeless but as health pmfessionals, we need to educate
our patients about realistic goals, encouraging them (if
they actually have a weight problem, and not a body-image
problem) to make small permanent changes in diet and exercise
to have permanent weight loss. And if the product says that
you will lose tons of weight without giving up favourite
foods or ever feeling hungry or doing strenuous exercise,
you're being conned.
Size acceptance is a minefield of human rights issues, social
and practical concerns, and medical issues as well. With
considerable exposure to this movement, I have never seen
anyone pushing family or partners to gain weight, just advocating
for the best possible health and trearment for those who
are truly obese.
Carol Kostynuk is the president
and medical director of the Eating Disorder Education Organization,
which can be contacted at at 944-2864. The group's website
- www.edeo.org -includes information on its all-size fashion
show in February, which is Eating Disorder Awareness Month
in Edmonton.
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