Obesity Prevention and Eating Disorder Prevention

When I ask people to care about eating disorders, it is very common for them to come back with "but obesity is such a big problem." I'm not sure why the two things are seen as opposites, but I think we'd benefit from taking a different look at both issues that may lead us to see some common goals and a common approach.

Obesity is just a description of a weight class. It tell us nothing about the health conditions of that person. It doesn't mean the person has an eating disorder, though it often does. Being underweight is not an eating disorder either. People with eating disorders often do lose weight, but may be average weight. Underweight is also just a crude measure of physical state and not a diagnosis: many things cause weight loss.

Obesity Prevention and Eating Disorder Prevention: Do We Know How?

We talk a lot about "obesity prevention" and "eating disorder prevention," but if you examine the evidence for both concepts you'll probably note, as I do, that we really know very little about how to prevent obesity or eating disorders. The only thing we can agree on is that both are complicated issues and that society has strong feelings about both. A common factor: the belief that people choose their weight and can decide to choose another weight.

Ridicule and prejudice against larger people is rampant and vicious out there. I am constantly shocked at how otherwise nice people feel free to speak disparagingly and condescendingly about, and even to, people based on their body size. I imagine this is much like people unthinkingly behaved about people of a difference race in earlier times - reflexive and unquestioned bias.

Changing the Goal to Health Instead of Weight

One way to stop pitting obesity against eating disorders is to realize that they aren't opposites. There is a lot of evidence out there that "obesity prevention" does little good but does cause increased prejudice and, yes, disordered eating. The kind of measures people take to lose weight are usually extreme and unhealthy and futile.

Healthy eating and exercise, on the other hand, are good for everyone. Instead of basing our eating and activity on our weight, we can nourish ourselves and be active according to the needs of our bodies - that's not dieting it is self-knowledge. Behaving in a healthy and balanced way may affect our weight or it may not. But for those with eating disorders - a mental illness that makes it difficult to meet one's nutritional needs - it isn't enough to say eat when you're hungry and stop when you're full. Eating disorders require specialized treatment and not just weight management. Again, let's get off the weight and back to health: mental and physical.

For good advice on this issue, I enthusiastically recommend: "AED Guidelines for Childhood Obesity Prevention Programs" and "Preventing Obesity and Eating Disorders in Adolescents: What Can Health Care Providers Do?"