Thursday, July 19, 2007

The fat wars and eating disorders

I was going to post this as a comment to the last post, but I feel it needs its own thread here.

I'm so sick of hearing that "eating disorders affect a tiny percentage of the population, but obesity kills thousands."

There is ample evidence that obesity does not kill anywhere near the numbers originally released by the CDC. But that's not where I want to go with this today. Even if it were true, this attitude makes me sick. It's like saying, "Losing a few people to e.d.s is worth it, if the rest of the fatties shape up and lose weight."

As some of you know, my daughter almost died of anorexia, an eating disorder that has the highest mortality rate of any psychiatric illness--up to 20%. It's true that diagnosed eating disorders affect only a small percentage of the population—but they are a very real and very significant problem. Especially if it's your child, your niece, your best friend's daughter.

The argument over whether fat is unhealthy or not is not merely an exercise in fat-bashing and prejudice. If it were, well, as someone said earlier, we could indulge in it until the amusement factor wore off and then be done with it. But there are real, heart-breaking consequences to this. And one is that we are now seeing an unbelievably rabid set of anti-fat messages directed at a vulnerable population: kids ages 8-15. Middle school is a time when just about every kid is horribly self-conscious about bodies to begin with. It's also the average age of onset for eating disorders--in the 13 to 15 range. I think we're going to see a rise in anorexia and bulimia as a direct consequence of this messaging. Anecdotally, I know of many families (including my own) whose eager-to-please children started trying to "eat healthy" in middle school and for a variety of reasons (including genetics) went too far and wound up with AN or BN. For those who are susceptible, this kind of pressure will certainly trigger eating disorders.

So this isn't an academic exercise. There is and will continue to be a very real fallout from the "just eat healthy" messaging. Children, families, and adults will suffer. If you've never really known someone with an eating disorder, let me say that you have NO IDEA how much that person suffers. And not just that person, but their family, and friends. Having anorexia is like living with a demon inside you that torments you 24 hours a day, 7 days a week. There is no vacation from e.d.s. They take over your life. You have no life outside them.

And too many of these sufferers will die. Yes, die from eating disorders. And these young women and men are not negligible. They're not collateral damage in (yet another) stupid, ill-advised, mismanaged war. They are our daughters and sons. And I say, enough.


Rachel said...

Agreed - the anti-fat hysteria is going to have massive repercussions, already evidenced by the rising numbers of ED victims, some as young as 6 years old. Fat has become so reviled and so hated, that many will stop at no lengths to prevent it.

Carrie Arnold said...

And even those ED sufferers who survive- many of them are chronically ill, or compromised in some other way. I was lucky. I've made it to the other side (more or less...depends on my mood). Fat doesn't kill...prejudice against fat does. Both for people who are fat and for people afraid of becoming fat.

HarryB said...

I couldn't agree more. The so-called "war on obesity" is likely to take many victims....individuals who develop significant eating disorders such as anorexia nervosa or bulimia nervosa which carry exceedingly high morbidity and mortality. Encouraging kids to diet is a big mistake. Many of the messages from the "war on obesity" are virtually the opposite of messages the very same individuals are receiving from those trying to curb eating disorders. If interested, there is more information about this topic in the news section and the forum section of our website at:

Harry A. Brandt, M.D.

HarryB said... the site's:

mary said...

When my husband was a boy and ED's were not really heard about as they are today, he went to school with a girl who took the messages that she was fat, by bullies of course, to such an extreme that she stopped eating and starved to death. She was only around 8yrs. old and no one knew how to help her as they all stood around feeling helpless. This was many years ago but the impact it left was powerful.
The new 'bullies' seem to be those who should know better but are more concerned with the almighty dollar than with what true health might be.
Imagine if we lived where we could just be comfortable being the size our own genetics determined? How dare we, they'd say.
Sure there'd be those who needed to learn that we can't live on cream puffs, as heavenly as it may seem and that balance helps. Sure there will be those who will need to learn eat when they are so fascinated with a project that they forget to fuel their body because that's the kind of person they are....not me, I can munch while working being great at multi tasking.
Harriet, keep following your passion. It's so hard to educate a world that's been brainwashed into thinking that fat=disgusting. You are taking on a culture that 'the people' have lost a voice in deciding what's IN and what's NOT, and we need to take it back.
I think it's time has come that being ourselves should be 'IN'. ALWAYS.
Naturally,I have more thoughts on why we are being warned away from back later. ; )

Anonymous said...

Hi, I find your comments very interesting, especially about eating disorders in children. I think we have media overload of young, scarily thin women. It's hard to shake those images and not feel huge. We have a clothes line for girls 7 to 12 who have a hard time finding clothes that fit. We're, and we would love feedback on what girls need or would like to wear. Everyone deserves cute clothes that aren't dowdy! It's ridiculous how hard it is to find them in plus sizes for children.

Anonymous said...

I think an important thing people need to realise that even fat people can have eating disorders that aren’t to do with constant overeating (and that the solution is not a diet AKA “lifestyle change”).

A blog linked to yesterday from Big Fat Blog is from an awesome woman who’s a triathlete - and 300lbs. Her introduction post has a sad tale, especially in the light of new evidence that eating disorders are increasing due to obesity hysteria and how fat people are treated very badly by health care workers. It’s at .

Harriet said...

You're so right. It's not just death--it's the death-in-life that can result from living with an eating disorder long term. I'm so proud of you for fighting the demon.

I've heard good things about Shepard-Pratt. I'd love to talk with you offline about your treatment modalities. I'd be interested in knowing whether you use Maudsley, for instance. Please feel free to contact me at hnbrownattdsdotnet.

What an awful story. However, I cannot wait to see what you come up with next! ;-)

Emily, your site looks cool!

Anonymous, I read that post on BFB and then read some on her blog. It's sad but also so very inspiring. She is very cool.

Thanks for sharing, all. I feel a little better knowing I'm not the only one out here with these feelings.

mary said...

The girl I spoke of died in a hospital which at the time didn't have the ability to follow it's gut the way many of the maudsley parents and other non maudsley but fight back parents we have today. I am sorry to have written it but it's a truth that brings home the reality of ED's. The girl was chubby to begin with but her young spirit was crushed by bullying. I wonder if the adults knew of this part of her illness. My husband being a kid heard the bullies so he knew of her torment.
How genetics fit in is where I feel your message begins, that we can't keep risking giving people the message that they are somehow less than enough if they don't fit into a the perfect little grouping they say we belong in. They are wrong! This goes not just for weight and height but also for ways we learn and think differently. Together we are the spice of life. When everyone is the same it's bland, bland, and more bland.
I'd have children in K learning to respect differences and their teachers learning this too , if I had my way. Some say we are crossing into moralities but I think the gov't already did this. Isn't telling people they are too fat crossing a line?
I think that kindness can be nurtured, taught, and expected. Teach health but leave judgments out of the equation.
Bullying is way too common and sadly expected by many school systems. Rather than helping they tend to feed the problem by negligence. Some teachers join in!
While I found many parents who agreed with me I also learned that they feared standing up and exposing themselves for greater risks. If parents can't stand up for kids then who will?
How I drift from the fat hysteria to education I'm not sure but I know the connection is there.

Anonymous said...

One of the things that bothers me about the "war" on obesity is that it often seems to be a war on the obese. Aren't we supposed to sympathize with sufferers? Instead, we often attack them. And although I know that obesity is not necessarily more prevalent in lower-income and nonwhite people, there seem to be classist and racist elements to much of the discussion of obesity.

Anonymous said...

Oh, and I should also say that people with eating disorders often are treated with disdain and contempt as well. That is one factor that makes it hard to come out of the closet when a person or a person's family member is suffering. On this same note, I get angry when people talk about our health care system and say that the problem is that people are "abusing" the system ... by getting sick (instead of the problem being what it is, the rapacious insurance companies and health maintenance organizations).

Harriet said...

Such an excellent point, anon. When we talk about kids with anorexia we often talk about the need to separate the child from the illness. Fatism is no different than racism or classism--defining the human spirit by skin color or socioeconomic status or how much fat there is or isn't on the body.

The war on fat is highly personal and becomes more so all the time. That's a function of "blame the victim" along with thin entitlement and, I don't know, a few other things thrown in there too, no doubt.

Unknown said...

It would definitely help if healthy food were less expensive. To live on only organic material will easily cost you several hundred a month. Pasta is less than a dollar a box. It seems like the manufacturing companies WANT to keep people overweight and under the addiction to food.

Anonymous said...

Oh, Harriet, it must totally rip you to shreds inside when people are so flippant about anorexia, after everything you've been through. "It's totally worth it to have a few thousand people die and a few million other lives ruined, just to make the general population a few pounds thinner!" Bleh.

I really do not understand this idea that if we gave people "permission" to be whatever size they naturally were, and eat their fill of whatever their bodies were craving, then everyone would pack on dozens of "extra" pounds. It shows a complete ignorance not only of basic human biology, but what happens to individual metabolisms as a result of chronic dieting. Some people might be heavier in a weight-neutral society (female celebrities and other women in "glamour professions," for instance), but it's not too farfetched to surmise that some might also be lighter, since they won't have trashed their metabolisms and wrecked their natural hunger mechanisms and tweaked their insulin responses dieting from a young age. Some people probably wouldn't change their eating habits at all. And some who did would probably demonstrate very little if any difference in their weight as result.

All I can say is, there are millions of other people out there besides our Vice President who "don't do nuance," and their inability to handle gray shades is pretty damn murderous.

Harriet said...

Too right, Meowser. I think that natural hunger mechanism is a very delicate balance, a natural homeostasis, and I suspect that once you start tinkering with it in any direction it's never really the same again.

I don't fault most people for not getting anorexia. I didn't either, before it got my daughter. I was as ignorant and clueless as anyone else--maybe more so, because I'd been raised on such a steady diet of, well, dieting. But I do think the medical profession should know better. Doctors see the results of eating disorders all the time. And of course I would hope that awareness would lead to sensitivity and understanding.

Anonymous said...

very useful post and comments, thankyou

Harriet said...

You're welcome--and you are welcome here!