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A Deadly Obsession

Women's Wellness Conference brings expert on eating disorders to campus

Anyone who has had more than passing acquaintance with an adolescent -- or remembers that discomfiting time -- knows that appearance often moves to the forefront as the most important thing in life.

Obsession with appearance and the perfect body can lead to eating disorders and impaired health, according to Jennifer O'Dea, M.P.H., Ph.D., from the University of Sydney, Australia, who was keynote speaker at a Nov. 14 Women's Wellness Conference, sponsored by the School of Nursing and the A.S. Women's Center.

Can intervention make appearance matter less to adolescents? O'Dea, an expert in preventing and treating eating disorders and a visiting scholar at the University of California, Berkeley, presented encouraging research results from a new self-esteem approach for improving body image, eating attitudes, and behaviors among adolescents.

Her self-esteem intervention study of 470 male and female adolescents found "significant and lasting improvements" in body satisfaction and physical self-esteem, and reductions in the importance of physical appearance, peer group acceptability, and athletic competence.

With a theme of "Everybody's Different," self-esteem activities focused on celebrating individual uniqueness; human diversity in growth rates, shapes, and sizes; self-acceptance; and tolerance of others.

O'Dea said that previous initiatives with a focus on providing information about unhealthy weight control practices and a negative focus on "good" and "bad" foods are now believed to do more harm than good by inadvertently promoting eating disorders and fear of food. Instead, the self-esteem approach takes a "positive, nonblaming" approach, with a primary goal of "First, Do No Harm."

This study, O'Dea said, demonstrates that young people need to feel secure in the belief that they will always be loved and accepted, whatever their appearance. "Why should someone's weight affect close friendships, social acceptance, self-worth, even scholastic competence?" she asked. The societal stigma for overweight girls is similar to racial prejudice, she said, declaring, "We cannot tolerate this."

O'Dea laid the blame for the increase in eating disorders and body dissatisfaction on capitalism. The "slim ideal" has been marketed to women since the 1950s, she said, tracing its depiction in advertisements. Today, she said, "beautiful" means 20 percent underweight "and declining."

She cited a British Medical Journal report of a study of store mannequins from the 1920s to the 1990s, which also revealed the progressive marketing of the "slim ideal." By the 1960s, she said, these mannequins, had they been real women, did not have enough body fat for menstruation. By the 1990s, they couldn't even have stood up.

She also showed illustrations of the "normal female figure" in medical textbooks from 1840 to 1981, with the body becoming progressively thinner.

All this, O'Dea maintained, has contributed to the rise of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, EDNOS (eating disorder not otherwise specified), and disordered eating, which includes extreme dieting, fasting, vomiting, pills, laxatives, and smoking to control weight. Up to 45 percent of college-age women have disordered eating, she said.

The health risks of eating disorders include constipation and bowel damage, impaired growth, menstrual disturbance, osteoporosis, poor concentration, and fatigue.

"Let's not try to get women to lose weight," O'Dea appealed. "Let's get women to be healthy." Women can carry extra body weight, she said, and still be fit.

O'Dea also cautioned that eating disorders are not limited to females. Image marketing to males has been growing since the 1980s, she said, displaying a men's magazine with articles on "blasting biceps" and "legendary legs." Such publications are marketing insecurity, she said. The greater emphasis on male body image increases the risk of steroid abuse, she said, as well as the range of eating disorders.

O'Dea cited a new area of concern for health professionals: exercise disorder. This is still being defined, she said, but she thinks that anyone who isn't a professional athlete and is doing more than two hours of exercise per day has an exercise disorder. Such individuals are obsessive about exercise and often become panicky if they can't exercise.

The Women's Wellness Conference also included presentations on women and heart disease, hormone replacement therapy, breast cancer early detection and prevention, new contraception methods, and building strength with yoga.

Francine Gair