Why do the negative health effects associated with thinness and attempts to be thin receive relatively little attention when compared with obesity?

Chapter 15: Weight and Appearance 477

Sources: Spearing, M. (2001). “Eating Disorders: Facts About Eating Disorders and the Search for Solutions.” National Institute of Mental Health, http://www.nimh.nih. gov/publicat/eatingdisorders.cfm, accessed August 9, 2010; Soriano, C. G. (2004, June 22). “Mary-Kate Olsen Seeks Treatment for Eating Disorder.” USAToday. http://www.usatoday.com/life/people/2004-06-22-olsen-treatment_x.htm, accessed August 9, 2010.
Costs of Thinness

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Eating disorders such as anorexia nervosa and bulimia nervosa are increasingly common weight-related health issues that receive less attention than obesity and overweight. Anorexia and bulimia involve disordered eating behavior, such as eating very little for extended periods of time or eating extreme amounts in a short period of time, coupled with measures to binge or purge oneself of the food consumed. Both anorexia and bulimia are associated with intense fear of weight gain, inappropriate behavior to prevent weight gain, often including misusing laxatives, diuretics, or enemas, and excessive exercising.

Anorexia is essentially self-starvation. In response to being starved, the body slows down its processes to conserve energy. Negative health effects associated with anorexia include dry, brittle bones (osteoporosis), muscle loss and weakness, hair loss, severe dehydration (sometimes resulting in kidney failure), and disrupted menstrual cycles. Bulimia involves recurrent episodes of binge eating, sometimes accompanied by purging. The binge-eating episodes may last for hours or days, followed by guilt, disgust, and shame. Those suffering from bulimia are likely to be average or above average weight. Negative health effects resulting from bulimia include swelling of the stomach or pancreas, tooth decay (resulting from vomiting), abnormal heart rhythms, and muscle spasms.
Anorexia and bulimia cross racial, ethnic, age, and gender lines; however, young women are significantly more likely to develop them than others. Estimates suggest that between 0.5% and 3.7% of females will suffer from anorexia at some point in life and that between 1.1% and 4.2% will have bulimia at some point. The mortality rate for those with anorexia is 5.6% per decade, or twelve times higher than the death rate due to all causes for young women in the population. The most common causes of death due to anorexia are cardiac arrest, electrolyte imbalance, and suicide. After battling anorexia for many years, Karen Carpenter, a popular singer from the 1970s and 1980s, died at age 32. French actress and model Isabelle Caro, whose emaciated body appeared in an anti-anorexia ad died at age 28 in December 2010.52 Mary-Kate Olsen, Jane Fonda, and Sally Field have also reportedly suffered from eating disorders.

Questions to Consider
Why do the negative health effects associated with thinness and attempts to be thin receive relatively little attention when compared with obesity?
Investigate mortality rates for obese young women. How do these rates compare with those for young women suffering from anorexia or bulimia?
,2″Isabelle Caro Dies After Anorexia Struggle.” http://www.guardian.co.uk/society/2010/dec/30/isabelle-caro-dies-model-anorexia, accessed January 1, 2011.

Misperception: Thinness is always healthier than heaviness. Reality: Excessive thinness and excessive weight are both unhealthy.

The widespread dislike for fatness, its clear visibility, its perceived association with many negative personal attributes, and the lack of widespread sanctions for discrimination on the basis of fat all contribute to continued discrimination. Research on stigma provides some clues to understanding fat discrimination. Stigma theory suggests that those whose attributes deviate from the typical, normal, or preferred attributes of others in a situation may be stigmatized and this stigmatization will result in various negative outcomes.J3 Since two-thirds of the U.S. population is now overweight or obese, the “typical” or “normal” person is no longer thin. Stigmatization appears instead to result from deviance from preferred attributes rather than common or normal attributes. As discussed earlier, women suffer more negative consequences for being overweight than do men. Several authors suggest this is partly a response to media images that portray nearly all women as unrealistically thin and ignore larger (normal) women, resulting in greater preferences for thin women/4 Even “plus-sized” models are often smaller than the “average” woman. Since the images of women’s thinness are so pervasive and so strongly equated with beauty, women who deviate from these images are penalized by society, including employers and health care providers.

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