A controversy is brewing about how to best address the rise of overweight and obese youth in the United States while also preventing eating disorders that can inadvertently be encouraged by the very behaviors suggested to help control weight.
Some eating disorders advocates believe that emphasis on weight charts, body mass index (BMI) and culturally-influenced expectations of body type are not effective motivators for most individuals to embrace a healthy lifestyle. A general emphasis on appearance and weight control, and a preference for thinness by parents and peers can contribute to body dissatisfaction, dieting, low self-esteem and weight bias among today’s youth (NEDA, 2010).
BMI, which is calculated from a person’s weight and height, was first used as an international obesity measurement in the 1980’s. According to the Centers for Disease Control, a BMI of 30 or greater indicates obesity. As it is, obesity is a major health risk factor for various issues, including cardiovascular disease, certain types of cancer and type 2 diabetes. Within the decade, the public became more familiar with BMI because of a government-sponsored initiative aimed at encouraging healthy eating and exercise habits. By the 1990s, the National Institutes of Health lowered the “overweight” threshold for BMI from 27.8 to 25, essentially telling 30 million Americans, who were previously considered to be a healthy weight, that they were now “overweight.”
While BMI is used as an obesity measurement, it does have limitations. The calculations may overestimate body fat in athletes and others who have a muscular build or underestimate body fat in older persons and others who have lost muscle.
Despite these limitations, it seems that many groups, from popular diet programs to athletic trainers and coaches and even some in the medical profession, have elevated the role of the BMI measurement, creating an unhealthy, myopic focus on body fatness as the one measure of a person’s health.
The Eating Disorders Coalition for Research, Policy & Action (EDC) highlights that BMI is not based on scientific evidence and therefore should not be used as a “meaningful measure of weight and health.” Currently, the EDC is urging policy makers to steer away from legislation requiring schools to measure and report a student’s BMI to parents as a strategy for combating obesity.
Such legislation could result in people being too focused on a number as a gauge of overall health, potentially leading to an increase in the weight-controlling behaviors that can lead to an eating disorder. It is important to consider whether a measure may increase the occurrence of eating disorders, as they are a major health concern in the U.S. An estimated 10 million females and 1 million males are fighting a life and death battle with an eating disorder such as anorexia or bulimia with millions more struggling with binge eating disorder. Sadly, eating disorders have the highest mortality rate of any mental illness. And of those who suffer from an eating disorder, 95% are between the ages of 12 and 25 (NEDA, 2010). While widely stigmatized as a “white” and “female” condition, new studies reveal a rise in eating disorders among boys, people of color, athletes and those from lower socioeconomic backgrounds (EDC, 2010).
National Eating Disorders Awareness Week is February 20 -26 and offers a week-long opportunity to educate and raise awareness about the perils of eating disorders and disordered eating with the whole community. Now is the time to bridge gaps in your community by forming relationships with health and wellness clinics, gyms, athletic clubs, and schools, among others. The result, hopefully, is a renewed focus on overall health and vitality rather than an obsession with weight, percentages and BMI. The hope is that community based organizations can work hand-in-hand with other local organizations to help guide individuals toward a healthier relationship with food and exercise.
Take advantage of the resources available through Eating Disorder Hope, National Eating Disorders Association, Eating Disorders Coalition and others to broaden your education and prevention efforts from a focus on weight to a focus on wellness for everyone in your community.