Professional Documents
Culture Documents
6 • November/December 2001
HEALTHY
WEIGHTJOURNAL
RESEARCH, NEWS, AND COMMENTARY ACROSS THE WEIGHT SPECTRUM
CONTENTS
Obesity and Body Image
Editorial: The Global Epidemic of Obesity:
Among Diverse Populations
Why Global Approaches Won’t Work 81
Wayne C. Miller, PhD
NEXT ISSUE
News Briefs: Eating disorders found to be clinically similar in 82
The Federal Trade Commission men and women • Activity-related factors and body size perceptions
and the Partnership for Healthy
Weight Management associated with urban girls’ obesity status • Smoking initiation
associated with dieting frequency among adolescent females
• Night eating syndrome and related psychopathology • NIH funds
large study on the effects of weight loss and exercise on type 2 diabetes
• Prepregnancy weight and the risk of pregnancy complications
Farewell 84
Frances M. Berg
Articles:
Human Culture and the Global Epidemic of Obesity 85
Steven R. Hawks, EdD
Physical Love 96
Susan Stinson
Index 96
ARTICLES ON-LINE
“Exercise Considerations for Diabetes” from Healthy Weight
Journal, Vol. 15, No. 5 is now available on the Web at
http://www.bcdecker.com/exercise.
BC Decker Inc
HEALTHY WEIGHT JOURNAL E D I T O R I A L
Volume 15, No. 6 November/December 2001
Eating disorders found to among this group of adolescent females than the
activity-related behaviors. The researchers emphasize
be clinically similar in men the importance of school physical education programs
and women for minority populations and suggest that health
The results of a large Canadian study found few promotion efforts should be focused on reducing
clinical differences between men and women with inactivity and increasing physical activity. They also
eating disorders. The study used data from a stress the importance of developing such programs
community epidemiologic survey to compare 62 men within an appropriate sociocultural context using the
with full or partial eating disorders with 212 women knowledge, attitudes, and behaviors of members of
with eating disorders and 3,769 men without eating the community. (Gordon-Larse P. Obesity-related
disorders. The men and women with eating disorders knowledge, attitudes, and behaviors in obese and
had similar psychosocial morbidity with the nonobese urban Philadelphia female adolescents.
exception of depression, which was found to be Obes Res 2001; 9:112–118)
higher among women, and substance abuse, which
was found to be higher among men. However, the Smoking initiation associated
men with eating disorders had more psychiatric
disorders than men without eating disorders. The
with dieting frequency among
authors stated that it was unclear whether the higher adolescent females
prevalence of psychiatric disorders among men with It has been speculated that weight concerns may be
eating disorders was the result of the eating disorder an underlying factor in the initiation and
or a factor contributing to the development of an maintenance of smoking among girls and women.
eating disorder. (Woodside D, Garfinkel P, Lin E, et Findings from a recent study appear to strengthen
al. Comparisons of men with full or partial eating that hypothesis. Researchers followed 932 sixth- and
disorders, men without eating disorders, and women seventh-grade girls and boys for 2 years to examine
with eating disorders in the community. Am J dieting frequency and smoking initiation. The results
Psychiatry 2001; 158:570–574) indicated that girls, who at baseline reported
restricting dietary intake once per week or less, were
Activity-related factors and almost twice as likely to become smokers than girls
who reported not dieting. Girls with weekly
body size perceptions associated restrictive dietary behaviors were nearly four times as
with urban girls’ obesity status likely to become smokers than girls who were not
Obesity-related knowledge, attitudes, and behaviors dieting. No association was found for dieting
were compared between 32 obese and nonobese frequency among boys and smoking initiation. It was
matched pairs of African-American adolescent females concluded that for girls, dieting in early adolescence
to determine how such factors may influence obesity. increases the risk of becoming a smoker. The authors
Researchers measured the adolescents’ self-concept, suggested that concern over weight may be the
eating attitudes, body image, health behavior underlying factor for both behaviors, dieting and
knowledge, dietary intake, physical activity/inactivity, smoking, and that dieting itself may be a potentiating
and maturation status. Self-esteem, eating attitudes, factor that heightens the risk for smoking. (Austin S,
health behavior knowledge, energy intake, energy Gortmaker S. Dieting and smoking initiation in early
intake from fat, and age at menarche were not adolescent girls and boys: a prospective study. Am J
significantly different for obese and nonobese females. Public Health 2001; 91:446–450)
However, the results did indicate that the obese girls
spent significantly less time in light to moderate Night eating syndrome
activity and more time engaged in inactivity than the
nonobese girls. Obese adolescents were also found to and related psychopathology
have a significantly larger perception of ideal body Although night eating syndrome (NES) was identified
size than the nonobese adolescents. Overall, except in the literature over 40 years ago, it has recently
for ideal body size perceptions, knowledge and started to attract more attention. Individuals with
attitudinal factors had less of an impact on obesity NES have been described as having morning anorexia,
Economic production
Free-market economy Urbanization, mechanization, rising income, Walking/biking trails, activity centers
Industrialization cheaper foods, sedentary lifestyles, leisure, at work, central stairways, school
loss of traditional diets activity programs
Social order
Division into classes Aggressive food ads target children, food as National policies that regulate food
Corporate profiteering a source of status, more food processing ads, subsidies for nutritional foods,
(adding fat, sugar, salt), food as a social cultural support for traditional diets,
bond or a means of escape/relaxation mass nutrition education
Cultural beliefs
Body size = beauty If food is scarce, big is better; if food is Promote health at any size, focus on
plentiful, thin is beautiful (both views nutrition and fitness—not size
may promote obesity)
a cause of eating disorders, and detrimental to per- relationship with food, that all obese persons have
sonal health. On the other hand, health at any size body image disparagement, that all obese people
supporters have been accused of making accusations have low self-esteem, and that all of the obese will
without scientific evidence while overlooking the respond to cognitive behavior therapy. In other
existing data. words, the health at any size approach is focused on
If one were to look at the two paradigms simul- Caucasian women with a single psychological pro-
taneously, one would see that both paradigms have file. Although individuals of other cultures may not
the same major flaw. Both paradigms are subscribing experience the same psychological impact of obesity
to the philosophy that “one treatment fits all.” as Caucasian women, the incidence of obesity occurs
Those who believe that weight loss through restric- disproportionately in other racial/ethnic groups.
tive dieting and exercise is the means to health con- Accordingly, Ann Jacob and Steven Hawks
tinue to search for that one optimal diet and exercise address some culturally sensitive issues and propose
program that will solve the obesity problem. They alternative approaches for the treatment of obesity in
give no consideration as to how cultural influences various racial/ethnic groups. It seems that culturally
of various racial and ethnic groups might prohibit or sensitive, community-based interventions that can be
undermine certain aspects of diet and exercise pro- individualized will be the key to fighting the global
gramming for weight loss. The proponents of the epidemic of obesity.
health at any size paradigm, on the other hand,
assume that all obese individuals have a problematic Wayne C. Miller, PhD
I N D E X
Adolescents, 59–60, 66, 82 Berg, Frances M., 1, 8, 17, Body Wars: Making Eating Disorders and
Advertising, 45 27, 28, 36, 48, 49, 61, Peace with Women’s Obesity, 48
African-Americans, 4–5, 7, 84 Bodies, 32 Medical Issues and the
82, 90, 93 Binge eating, 43 BodyWise: Eating Eating Disorders, 28
AIDS/HIV, 67 Birch, Leann, 51 Disorders Information That Body Image Thing:
Airlines, 63 Blood pressure, 12, 66 Packet, 31–32 Young Women Speak
Allison, David, 38 BMI. See Body mass index Dietary Guidelines for Out, 31
Anorexia, 22, 27, 28, 29, Body fat, 2, 10, 90 Americans, 15–16 Volumetrics: Feel Full on
34, 35, 66 Body image, 22, 30–32, 34, The Don’t Diet Live-it! Fewer Calories, 75, 80
Atlanta (Ga.) Anti-Eating 56–57, 82, 93–95 Workbook, 47 A Waist is a Terrible
Disorders League, 25 Body mass index (BMI), Great Shape: The First Thing to Mind, 31
10–13, 18, 39–41, 67, Fitness Guide for Large Bopp, Christopher M., 68
Barbano, Cathy, 20 83, 90, 91 Women, 80 Breast cancer, 66–67
Beautiful Project, 22–24 Bone mass, 66 KidsWalk-to-School, 16 Bruner, Jack, 3
Beauty, 2 Books The Management of Bulimia, 28–29, 67