Tuesday, June 12, 2007

Another reason to look beyond weight and BMI

The New York Times reports the results of a study showing that young women who weigh enough to menstruate may still be eating too little to be healthy. Researchers at Ohio University found that bone formation, which is critical in adolescence, may not be taking place even if women get regular periods.

This is relevant because doctors so often use menstruation as a marker of health among those recovering from anorexia. But it's clearly not the criterion to live or die by.

Here's the money quote, to my mind: “Regular menstrual cycles do not reliably indicate that they are eating enough for what they’re expending,” Dr. Loucks said. Read more about it here.

8 comments:

carrie said...

Harriet,

This is so true. During the 7 years of my anorexia, I only lacked a menstrual period for about 9 months. Yet I developed osteoporosis after just a year of onset.

And how many young children are going to grow up with less than optimal bone density because of widely hyped obesity fears?

Katy said...

I'm glad SOMEONE read this article...I was afraid it would get lost in the junk heap of the anti-obesity polemicists.

Kate Harding said...

Yeah, I can see that being a milestone for a girl/woman recovering from severe anorexia, but it never occurred to me that they'd use menstruation as a marker of good health. More like a marker of "less likely to die in the near future."

I would also really, really like to see more attention given to the studies that show fat carries numerous health benefits for seniors -- one of those being that they're much less likely to break bones. People don't seem to think much about how vital strong bones are -- and how dieting can cause bone loss -- because of course, you can't see the bones. You can only see the fat.

Just one more thing that gives lie to the notion that people are worried about "health," not about looking fat.

(Sorry for the tangent.)

Harriet Brown said...

Not at all. It's all important stuff. Part of what motivated me to post this was a conversation I had recently with my d's pediatrician, who supported us all through the year of doing Maudsley with her. I had brought her in because I was feeling like a tiny bit of backsliding was going on. My d is weight restored but very athletic, training hard at several sports. And I was feeling uneasy about the fact that she'd maintained weight but built muscle, so she was losing body fat. The dr only wanted to know if she was menstruating, and when I said yes, she basically blew off my concerns. Well, I was right, as it turned out, and I will never again ignore that niggling feeling of something being wrong. And I was glad to read this validation of the fact that menstrual cycle alone is not a criterion for good health.

And oh yes, I am with you, Kate, on the fact that fat clearly has a protective value for older people. I bet we find out someday that dieting for older people is just as risky behavior as it is for adolescents.

Kate Harding said...

Good for you for listening to your maternal instincts, Harriet. And I'm glad for you, too, that this study validates what you already knew.

Also, confession time: when I made my first comment, I honestly thought I was commenting on another blog. :) I came here via Notes from the Fatosphere, didn't look at anything but the top post, and you have the same layout as Red No. 3. Had I realized where I was, I wouldn't have been so glib or rambly in my comment.

Glad to have found your blog, in any case. I just found the link to your Nov. 2006 NYT piece about your daughter at Junkfood Science. I actually remember reading that at the time. An incredibly powerful piece.

Rachel said...

Using menstruation as a marker by which to diagnose anorexia is so clearly flawed. By this criterion, no man can ever be diagnosed with the disease, despite the rising numbers of men with eating disorders.

mary said...

With all you've been through Harriet you need to trust YOUR instincts regardless of validation. I know how nice it is to be validated but with so many parents feeling unsure, partly due to bad advice and being told to step back and let the 'experts' do their thing, so we don't further break our children, those of us who are stronger need to be the voice that validates others. We are people who've studied this and come to learn more than we ever thought we would.There are things we CAN teach. I get frustrated at ignorance of those who are the 'so called experts' but I also know some of those experts probably do too!
While I hope to learn more I have found that trusting my own instincts,especially when they start gnawing on my rest and waking hours, a sure sign that somethings not right and I'm on to it! Listen well to yourself Harriet.You're no dummy. Teach your daughter that she too has an inner guidance that knows when things are wrong so she can reach out and ask for support. It's there, she just has to pay attention.
You are a wonderful, well attuned mom. Trust this even if no one else backs you up! I wish I knew more women like you when my d was in recovery.

Harriet Brown said...

Thanks, Mary--it's good to be validated by you. :-)