CHAPTER TWO: SOCIAL PRECIPITANTS
Pressure to be thin
Ours is a society consumed with thinness. Television, movies and magazines all emphasize that one can be loved, respected and successful only when thin. Fashion magazines saw a dramatic change from the rounded feminine figure of the 1950’s to the slim boyish figure of “Twiggy” in the 1960’s. A study by David M Garner Ph.D. of the number of diet articles published in six popular women’s magazines points out that from 1959 to 1978, diet articles increased from 17.1 articles per magazine in the first decade to 29.6 in the second (Squire, 1983).
Adolescents are extremely aware of their bodies and how they compare to their peers. The over-attention our society pays to physical beauty and the body type we accept as beautiful drives many healthy, robust girls to vigilant dieting and exercising. An eating disorder can begin as a mere diet to lose a few extra pounds and develop into the obsessive illness it is.
The thousands of products and services related to diet and exercise in a multi-million dollar industry are evidence enough of our society’s preoccupation with “thin” as the ultimate in beauty. Though this preconceived idea of correct body type, size and shape has nothing to do with a realistic body size for the majority of the population, the public is not deterred from a generally unsatisfying trek from one diet product to another, and more and more exercise gimmicks in pursuit of that model thin figure. Though eating disorders are found to afflict 10 – 20% of the population, a far greater percentage of Americans are discontent with their bodies and continually diet in an effort to fit an impossible ideal. Almost everyone wants to lose a few pounds or would like to change something about their bodies. Self-esteem and happiness are affected by gaining versus losing, staying in control of one’s diet, or “blowing it”.
We are constantly bombarded with media images of what we should look like. Car advertisements show thin girls slinking around sexy expensive cars. The various diet companies are in constant competition on our T.V.’s and radios. Rock and roll superstars are thin, as are most of Hollywood’s leading ladies.
Try having lunch out with a group of women friends. Is there anyone not counting calories, ordering a salad when she really wants pasta or not complaining when the meal is over about how she over-ate and feels guilty? And if we aren’t watching every morsel that goes into our mouths, how many spouses, boyfriends or mothers are? How many husbands remind their wives, “Do you really think you should be eating that, dear?”. Or well-intentioned mothers encourage teenage daughters to lunch on carrot strips and a hard-boiled egg instead of the sandwich that would really satisfy her hunger. The message is all around; for financial, social and career success, one best be thin. This is a national obsession. If you’re not worried about your weight, everyone else will be.
Garner et al make the following quote in their literature (Garner et all., 1985): It has been suggested that “public derision and condemnation of fat people is one of the few remaining sanctioned social prejudices … allowed against any group based solely on appearance” (Fitzgerald, 1981). There is evidence that obese individuals are denied educational opportunities, jobs, promotion and housing because of their weight (Bray, 1976; Canning and Mayer, 1966; Karris, 1977).
It is interesting to note that fat in certain other cultures is viewed quite differently. In Pacific island cultures a large woman is her husband’s pride. This is a sign of his success and ability to feed her well. In African and Hispanic cultures as well, a more voluptuous figure is desirable, particularly large hips and thighs. Our western culture must be viewed very oddly by the rest of the world, where starvation is self-induced in an atmosphere of plenty.
Garner et al discuss an interesting study which shows a trend towards increasingly thinner body types in both Miss America Pageant contestants and Playboy magazine centerfolds within a 20 year span. The ideal body type was depicted as having a smaller bust and hips, with a somewhat larger waist, which would give the person a more tubular, or boyish appearance. This is curious, they point out, because this trend towards thinness is actually in direct opposition to the actual changes in young women’s bodies over the last 25 years. Using Metropolitan Life Insurance weight tables, Garner et al found that the expected weight for women under 30 years of age increased at approximately the same rate as the average weight of Playboy centerfold models has decreased (Garner et al., 1985). Studies of the insurance profiles also showed that only about 5% out of 50, 107 female policy holders between the ages of 20 and 29 are as thin as the average Miss America Pageant winner between 1970 and 1978 (Garner et al., 1985). It is easy to see, then, that the challenge to meet society’s expectation of thinness has increased through the years.
The majority of women feel compelled to deny themselves food that would actually satisfy their hunger and taste good, in preference for low calorie and often unsatisfying foods. They often force themselves into an exercise program they don’t enjoy for fear of gaining weight, rather than for the simple enjoyment of the activity as most men do. If a woman prefers a pleasant walk on a country trail versus working up a sweat on a stair machine, then by all means she should do it. If working in the garden is preferable to a four mile run, then she should feel free to make that choice. The fact is, many women listen to the “shoulds” about weight, food and exercise, denying themselves many things they might enjoy, while pursuing an often unrealistic ideal of beauty. We cannot ignore women’s self-esteem as a cultural issue. Why do women feel so bad about themselves? For many centuries women have pushed and squeezed and puffed up different parts of their bodies in order to be considered desirable. Though we don’t use the same contraptions as our foremothers, we are still trying to defy nature in pursuit of that perfect shape.
It has been found that dieting and/or exercise taken to extreme can cause loss of reproductive functioning and sexual appetite. It is curious, then, that extreme thinness became the ideal body type for women. It defies a woman’s natural function in the cycle of life. Ancient cultures honored goddesses, of which many images have been found. Most show women with large breasts or abdomens to glorify their reproductive abilities, their earth mother qualities. As millennia have passed are we now to view women’s bodies as decorative, rather than functional; no longer the givers and nurturers of life, instead the object of fashioned industry whims.
It has also been found that excessive exercise in men can actually reduce libido, ability to perform sexually and the ability to reproduce by lowering sperm count. Our ideals have nothing to do with reality. The Adonis we consider so virile may not be able to express his virility at all. One wonders, if we were not under constant barrage by the advertising industry and the media, what we might actually chose for ourselves as an ideal for beauty and virility. We would probably be more content with ourselves and accepting of others.
Much has been done in recent years to dispel certain myths about fat and dieting. An eating disorder is dieting and concern about weight taken to a dangerous extreme. When one recognizes the pressure in this country to be thin, it is not difficult to see how an individual with psychological and biological factors might be driven to the obsessive and addictive behaviors of an eating disorder. It is valuable to consider the latest findings about fat and to begin to develop new ideas about one’s own body image and that of others. Understanding the body’s limits and compensatory mechanisms during starvation is an important aspect of healing, for the general public in need of more self-acceptance and particularly for the eating disorder patient. Dieters may starve in vain if working against the body’s natural defense of and optimum weight, a weight the organism chooses as normal.
Garner et al make the following points in their literature:
- In the past several decades, women have been victims of a tragic set of standards for physical appearance, which have placed them under intense pressure to diet to meet the social expectations for thinness.
- Generally speaking, body weight resists change. Weight appears to be physiologically regulated around a “set point”, or a weight that one’s body tries to “defend”. Significant deviations from this weight result in a myriad of physiological compensations amid at returning the organism to “set point”.
- Dieting is a relatively ineffective method of weight control, because it usually goes against these biological determinants of weight.
- There are marked interpersonal differences in “set point”; some people are naturally heavier and some naturally thinner. Most women’s “natural weight” is well above the current ideal for feminine beauty.
- Bulimia, as well as certain distressing biological and social changes, may be linked to chronic dietary restriction.
- Bulimia and vomiting become an escalating or vicious cycle, since vomiting allows the dieter to give in to her desire to eat without the fear of the caloric consequences.
- The gradual return to the weight that one’s body “prefers” leads to the gradual reduction of these symptoms, including the tendency toward binge eating.
Myths about fat and health risks
Traditionally, obesity is viewed as a health risk in and of itself, and even an indicator of psychological disturbance, such as depression or poor self-esteem. Researchers have found that the medical risks of obesity have been greatly exaggerated and misunderstood. Garner et al state that “it is an error to conclude that an association between obesity and illness necessarily implicates obesity as the cause”. Health professionals have been taught to assume that fat is unhealthy, and therefore all obese patients must be put on a diet for health improvement. This is a gross misassumption that recent research seeks to correct.
Genetics play an important role in the development of disease. There may actually be a genetic predisposition towards obesity as with diseases such as diabetes mellitus, high blood pressure and heart disease. Obesity and these other illnesses may originate from the same genetic deviation (Garner et al., 1985).
Research indicates a lack of support for the relationship between obesity and high blood pressure, heart disease, cholesterol levels and diabetes mellitus. Garner et al discuss a study done in a community where the incidence of obesity was high, but where it was considered a socially acceptable condition. The researchers found a lower than average frequency of heart disease and diabetes. In addition, there are studies that suggest that obesity is associated with reduced risk of illness and “in some age categories, obese individuals live as long or longer and survive illness better than their lean counterparts (Garner et al., 1985)”. Garner et al defend traditional studies regarding extreme obesity and its health risks. However, this literature states that “virtually no data indicate that mild to moderate overweight has the same detrimental consequences (Garner et al., 1985)”.
Kano points out that “higher weight also correlates with a lower incidence of cancer, some respiratory diseases, many infectious diseases, osteoporosis, some cardiovascular diseases, some gynecological and obstetric problems, anemia, diabetes type I, peptic ulcers, scoliosis and suicide. In addition, obesity is associated with a more favorable prognosis in diabetes type II, hypertension, hyperlipemia and rheumatoid arthritis (Kano, 1985)”. Additional research indicates that overweight individuals who are not considered “obese”, have the best chance of surviving to old age, and that individuals who are “model thin” have the least chance of surviving to old age; even greatly obese individuals have a greater chance of surviving to old age than model-thin women (Kano, 1985).
The weight cycling caused by repeated dieting is actually a greater health risk than strictly being fat (Garner et al., 1985). Individual’s whose weight cycles as a result of constant dieting, tend to regain their weight in the abdomen, which is associated with greater health risks. Likewise, the hypertension found in obese people is not necessarily caused by the weight itself, but is more a result of the cycles of weight loss and gain (Kano, 1985). Kano cites the example of Samoan women, who are quite large, and happily so, who rarely suffer from hypertension, nor do they try to lose weight and suffer from the complications of weight cycling.
Kano also adds clarity to studies which correlate high weight with cardiovascular disorders. She points out that “excess muscle is the primary risk factor for cardiovascular disorders. Those at greatest risk are muscular, have a large frame and carry fat predominantly in the abdomen” (Kano 1985), as opposed to people who are simply considered fat. The literature supports this phenomenon with studies that indicate when a dieter’s weight cycles they tend to gain fat in the abdomen, which is the most dangerous way to gain weight in regards to health risks.
There is much scientific data implicating the failure of dieting and achieving permanent weight loss (Garner et al., 1985). It should therefore be questioned as a cure for obesity. “Several studies and reviews have challenged the assumption that obesity is a significant health problem and have concluded that the fervor of treatment efforts reflects our prejudice rather than a realistic response to the risks inherent to the condition” (Garner et al., 1985). Even if there does exist some correlation between obesity and increased health risks, dieting is probably not the best solution a health professional can suggest. Garner et al states that “certainly the prescription of dieting is unwarranted for those who are not suffering from illnesses that are clearly complicated by obesity”. This is particularly true if the patient is not expressing any concern or anguish about weight. The National Association to Advance Fat Acceptance (NAAFA) cites this as a gross discrimination and injustice towards large people. When a fat person goes to the doctor, possibly for something completely unrelated to weight, it is often assumed by the physician that the weight is a problem. Here, once again, is pressure from society to be a certain body type. This is particularly unfair when one considers the documented gross failure rate of diets, and the humiliation and self-reproach experienced by those who “fail” to either lose weight or to maintain the weight loss.
Not only is it a myth that obesity is itself a health risk, it is also an unfair assumption that the obese person arrived at this condition due to psychological issues. The idea that fat people hide behind layers of flesh, that they have problems with sexuality, that they are depressed and thus gorge themselves with food, though certainly true in some cases, and certainly true among the general population, is a gross generalization and prejudice towards large individuals. Garner et al state that “while psychological factors may be responsible for overweight in some individuals, most controlled studies do not find the obese to be more neurotic, sexually inadequate, or emotionally disturbed than individuals of normal weight (1985)”.
As mentioned earlier, genetics to play a role. Burgard (1993) mentions a study by Stunkard (1990) which compared weights of identical and fraternal twins who were raised either together or separately. Stunkard concluded that genetic influences, rather than environment, determined body size. These findings support earlier studies of the same nature (Burgard, 1993).
Though there have been attempts to attach a particular familial pattern or personality profile to obesity, none have thus far been found (Burgard, 1993). There is no typical psychopathological picture, and “obese and non-obese individuals differ little in overall levels of psychopathology (Burgard, 1993)”. It is well to remember that, through depressed or dysfunctional obese individuals do come to the attention of mental health professionals, and their weight may in fact be a metaphor, symptom or result of a psychological issue, obese people who are functioning well, in satisfactory relationships, have commendable careers and high self-esteem, do not. It is difficult, in fact, for the general population to accept that large individuals might actually be happy, well-adjusted, have fulfilling lives and not feel bad about their weight. We are tempted to believe that, just as the bulimic or anorexic individual has a gross distortion of body image, so must the obese individual who does not seem worried about her weight. If she agonizes about it, trying to reduce and feeling worthless if she doesn’t, we see this as a much more normal reaction. This is the extent to which we relate thinness to happiness.
Burgard (1993) quotes Bruch, a notable leader in the study and treatment of eating disorders as saying “It is necessary to differentiate between those psychiatric aspects of the obesity problem that play a role in the development of obesity and those which are created by the obese state, in particular for people living in a culture that is hostile and derogatory toward even mild degrees of overweight; finally there are the conflicts precipitated by reducing”. The attempts to comply with the demands of a fat-hating society certainly cause psychological problems, particularly depression and low self-esteem. Many people in our society feel the pressure to be thin, the sense of “I’m only as good as my weight”, yet not everyone develops an eating disorder. However, it is precisely this social pressure, in combination with other factors, which drives the eating disorder patient to compulsive and dangerous behavior.
Based on these new attitudes towards obesity and health risks, in her work Burgard focuses on health and self-acceptance, not weight loss. Exercise for enjoyment and general well-being is explored for large women, as well as eating for good health and satisfaction of hunger. In an interview, she pointed out that in 1984 the National Institutes of Health (NIH) called obesity a killer disease. By 1992 the same organization had changed their opinion dramatically. They admitted to the failure of traditional treatment methods (i.e. dieting), warned the public about participating in commercial diet programs which could not show scientific data indicating long term participation and success rates, and recommended programs which focus on overall health benefits versus strictly weight loss, as a means of improving physical and psychological health.
Regular physical exercise does much to improve medical conditions such as hypertension and diabetes, reduces the stress often responsible for physical and psychological illness and improves body image, self-esteem and physical strength. An obese person engaged in regular enjoyable exercise might never achieve weight loss, but she certainly gains much in the way of overall well-being. Burgard suggests this must be the focus of healthcare personnel in treating obese patients. Take the focus away from weight loss and laboring in vain to match a weight on an insurance company’s chart, and strive for overall good emotional and physical health.
Myths about dieting and weight loss
Many studies have been done in recent years denouncing the effectiveness of restrictive diets as an effective and permanent weight loss solution. When one begins to understand the unique mechanisms the body utilizes to fight the starvation process, it is easy to see how people can become trapped in the endless and futile pursuit of the perfect diet. For the person with an eating disorder, it is an emotionally and physically painful battle against powerful forces of nature which seek to keep the body at its optimal weight for functioning.
Thus, experts have established a concept called “set point”, which is the body’s attempt to defend a physiologically programmed weight level. This “set point” is so individual and is influenced by such things as genetics and metabolism that it would be impossible to standardize weight based solely on age and height. One person might be lean at their set point, while another obese. Everybody has different energy (energy=calorie) needs. Consequently, the body makes it difficult to go below, and stay below, its optimal level for survival. This is a phenomenon of nature, which has to do with survival of the species, a physiological coping mechanism during the body’s perceived threat of starvation and extinction.
Garner et al discuss experiments by Keys et al in the Minnesota study performed in 1950, and Sims et al in 1968, which illustrate the resistance of most individuals to either gain or lose weight. Whether over-fed or under-fed, the body will find its way back eventually to set point. The studies show how metabolism slows down with weight loss so that calories will be used more efficiently and weight gain will occur. It has been found that dieting reduces the metabolic rate by 15 – 30% (Garner et al). And the longer one diets the more the metabolism slows down, so that it becomes more and more difficult to lose weight, and the dieter finds they must restrict intake even more than initially. The net effect, then, of dieting is actually paradoxical to the intent; the individual actually becomes more susceptible to weight gain and fat storage. Garner et al quote an interesting point form the literature of Wooley and Wooley, “that dieting – the major treatment for obesity – may also be a major cause of obesity”.
This is an important concept to grasp in understanding the bulimic’s addictive and frustrating cycle. If weight becomes increasingly difficult each time the bulimic begins a new diet, and the calories ingested during a binge are less likely to be burned off due to the body’s attempt to conserve energy from the starvation period, the metabolic rate remains suppressed because the body has no opportunity to recover from the starvation, and the calories are more readily stored as fat. So the bulimic actually begins to gain more and more weight due to the cycling, and rather than achieving her goal of weight loss through her erratic eating habits, she is actually gaining weight and making it harder and harder to lose (Garner et al).
A study using rats documents that the starved animals gained weight at a rate many times greater than that of rats of normal weight who were fed the same amount. Rats that were starved 20% below their normal weight gained 29.6 g during re-feeding, whereas the non-starved rates gained only 1.6 g during re-feeding, and the starved rats were eating somewhat less (Garner et al).
The bulimic patient is starved thereby she eats a far greater amount of food to compensate for the body’s need for calories. She feels physically uncomfortable and guilty, so she vomits. The vomiting imposes a break in the eating-satiety feedback loop. Where a person who eats normally would feel satisfied from the food and discontinue eating, the bulimic has relieved herself of the very mechanism which would lead her to stop eating. Instead, she is: 1) starved again and 2) giving herself permission to binge because she has gotten rid of the unwanted calories. The purge legitimizes the binge. She feels safe to continue eating. The purging initially starts as a method to control her out of control eating, but ultimately it only helps to continue the out of control binge-purge cycle (Garner et al). This cycle supports additional research which indicates that the incidence of binge eating occurs much more frequently in dieters than non-dieters (Garner et al). And dieters use food to deal with emotions during stressful situations much more than non-dieters.
Conversely, with weight gain above one’s set point, hyper metabolism occurs so that excess calories are wasted and the individual returns to set point. Regular aerobic exercise has been found to speed up the metabolism and to re-set the set point to a lower weight.
Changes in mood and appetite also promote return to set point. The studies showed that when subjects were fed well below their average level of intake they became completely preoccupied with food, planning how and when they would eat their next meal. While eating they would be completely focused on the food, would become silent and socially isolated while they devoted their full attention to the meal. This is characteristic behavior of anorexic patients, and it appears from the literature to be a symptom of starvation, and the defense of the body toward set point.
Another interesting observation of the Minnesota study was that if the subjects broke the prescribed diet, they became uncontrollable in their behavior towards food. They would binge, just as a bulimic patient, until they had consumed up to 10,000 calories in some cases. Then, so consumed with guilt, it was not uncommon to vomit and be filled with self-reproach (Garner et al). This is the common behavior of bulimic patients; starving themselves until the body screams to be fed, and then finding it impossible to stop due to the former deprivation. Once again, the body itself is making a vicious attempt to fight starvation and establish a normal caloric, or energy, intake.
Kano interviewed competitive wrestlers and rowers who traditionally employed severe dieting methods during their season. They experienced battles with set point and showed similar behaviors to eating disorder patients. The athletes would report starving themselves and restricting fluid intake prior to an event, then frequently bingeing afterwards due to feelings of starvation and deprivation. Though they would intend to keep the weight off even in the off-season so as not to put themselves through such a strict regimen during their season, the athletes would gradually gain back all of the weight once they had relaxed their eating patterns. These athletes had gotten well below their set points and could therefore not maintain such low weights without feeling starved.
The Minnesota study showed that the subjects underwent severe changes emotionally, physically, cognitively, socially and sexually while being starved. These specific complications will be discussed later in this course. However, what this illustrates, according to Garner et al, is the intense biological pressure on the body to return to “normal” weight. “It also demonstrates that the body is not simply ‘reprogrammed’ to adjust to a lower weight once it has been achieved. The volunteers’ experimental diet was unsuccessful in overriding their bodies’ strong propensity to “defend a particular weight level (Garner et al).” Once the subjects resumed their normal diets they did not gain significant weight. Within the first few months most gained back their original weight plus 10%. Then in the next six months their weight gradually declined back to their original pre-experiment weights.
This is interesting because it demonstrates the body’s resistance to exceeding set point as well as the converse. Sims et al conducted a study in 1968 using prison in-mates as volunteers who were over-fed, often up to 10,000 calories per day, in an attempt to gain between 20 and 25% of their original body weight. Most of the men gained a few pounds initially, but then found it difficult to continue gaining. Just as the subjects in the Minnesota study experienced metabolic changes to compensate for the decrease in calories, so did the volunteers in the prison study in order to defer weight gain. The starved subjects developed hypometabolism in an effort to conserve energy and thus use calories more efficiently, while the prisoners who were over-fed developed hypermetabolism in order to more rapidly expend the excess energy. It was found that these men perspired profusely and complained of body heat. This is a process known as “diet-induced thermogenesis”. The subjects had many complaints of physical discomfort as a result of the intense caloric intake and also experienced psychological problems. Once the experiment was over the volunteers lost weight rapidly and virtually re-established their pre-experiment weight levels without effort.
Kano discusses the importance of metabolic variance when considering weight gain or loss. Basal metabolism is affected by age, size, body composition (muscle: fat ratios) and gender. Even in individuals who are matched for all these characteristics, basal metabolism can vary by at least 15% to either side of the mean. Kano points out that studies show that “obese people consistently gain at least twice as much as lean people when they are overfed the same amounts”. Additionally, there are studies which show that fat people do not necessarily take in greater amounts of food or more calories than people of average weight (Burgard, 1993; Kano, 1985).
The use of laxatives and diuretics to aid in weight loss is also a myth. Laxatives have been proven ineffective in controlling absorption of calories. Laxatives effect the emptying of the large intestine, which occurs after calories have already been absorbed by the small intestine. Those who abuse laxatives are fooled into believing they have lost weight, because an acute weight loss is achieved which is mostly fluid. The body compensates for this with rebound water retention, which may then result in an even higher than original weight. The body simply won’t let us get away with anything! Diuretics have been found to have absolutely no effect on calories or body fat, and may cause water retention after discontinuation of use.
The diet industry exploits this phenomenon of water loss. The female body is comprised of 50% water. Most of the weight lost in the initial phase of a diet, particularly those with extreme calorie restriction is due to dehydration or water loss. This is how fad diets are able to make such seductive claims of instant weight loss. After the first few weeks, however, the weight loss is much less rapid because actual loss of body fat is slower than water loss. This is where many dieters become frustrated and discouraged and blame themselves for lack of will power. This is where a binge might occur, which would then lead to an even greater restrictive period, the feeling of starvation, binge and so on ad infinitum.
Chronic dieters, and especially individuals with an eating disorder, have gotten out of touch with their body’s needs and messages. They often do not understand, or accept, hunger as a communication of the body’s need. Nor can they perceive satiety before reaching levels of great discomfort from having gorged on food. Burgard feels that dieting encourages individuals to distrust their bodies and its signals. In treatment, Burgard re-introduces patients to their physical hunger and gives them permission to eat in accordance with these cues.
The dieter, and specifically the eating disorder patient, has “all-or-none” thinking, where certain foods are acceptable or good, and other foods are bad and forbidden. The dieter is then either “good” or “bad” based on her eating behavior. Self-esteem becomes completely predicated upon eating and weight. Is it any wonder that patients with an eating disorder become depressed, often suicidal and feel they are worthless failures? They can rarely achieve the impossible standards they have prescribed for themselves. Though they make a career out of dieting and being thin, their bodies vehemently resist such starvation levels, causing these individuals to engage in a constant battle against themselves.
Burgard discusses the fantasized future that often keeps the dieter disengaged with life in the present. The desired weight becomes the pot of gold at the end of the rainbow where all happiness can be found: “When I lose thirty pounds I will feel sexy, I’ll have a boyfriend, buy pretty cloths, take up dance, go to Hawaii and lie on the beach, go out to dinner with friends, etc..” The disappointments of life in the present can be staved off for the ultimate goal of the perfect future. However, so too are the joys of present life kept at bay. While the dieter feels she is not worthy of the good things in life until she’s thin, she puts off feeling good about herself, and treating herself well, simply for who she is, a valuable human being, capable of loving, being loved, having a good time and adorning herself attractively.
Dieting and the self-flagellating that women do over their appearances is the outer ramification of a deeper emotional issue, the subject of which has filled countless volumes, and that is the low self-esteem of many thousands of American’s women. It is interesting to note that Burgard found that dieters scored significantly lower than non-dieters on tests which measured self-esteem and feelings of self-control. This could indicate that those individuals, whether thin, of average size, or obese, who were able to accept their size and eat in an unrestricted manner felt better about themselves than those continually trying to change themselves through diet. Burgard poses that the repeated failure experienced by dieters maintains an overall sense of ineffectiveness and worthlessness.
In summary, fat is neither a sign of physical or psychological infirmity. Normal weight varies tremendously among the population, with some people being lean at their set point and others being large. In trying to control our body’s weight through diet we do little more than frustrate ourselves, and actually disrupt the body’s natural ability to monitor the number of calories we consumed and the weight it requires for optimal health. A wealth of literature supports the idea that dieting is harmful to overall health and can actually cause weight problems that did not exist prior to the diet. Individuals with eating disorders are an extreme example of this.
Next: CHAPTER THREE: PSYCHOLOGICAL PRECIPITANTS |