Overlap Observed in Obesity, Eating Disorders: Specialists Urged to Join Forces

Article excerpt

DENVER -- It's high time for specialists in the traditionally separate fields of obesity and eating disorders to join forces in an integrated approach to prevention and treatment, said Diane Neumark-Sztainer, Ph.D., at an international conference of the Academy for Eating Disorders.

The rationale for this proposal lies in growing evidence that obesity and disordered eating often occur together. Interventions focusing on just one may have the unwanted iatrogenic effect of promoting the other, she commented.

For example, public health messages encouraging people to consume fewer calories and restrict portion sizes may cause individuals with a high degree of body image dissatisfaction to go overboard and sink into an overt eating disorder, said Dr. Neumark-Sztainer of the University of Minnesota, Minneapolis.

The considerable overlap between obesity and disordered eating was recently documented in Project EAT (Eating Among Teens), a large population-based study headed by Dr. Neumark-Sztainer.

Project EAT, funded by the Health Resources and Services Administration, assessed 4,716 Minneapolis-area adolescents. The teenagers filled out a 221-item questionnaire addressing weight-related concerns and behaviors.

The observed overlap between obesity and disordered eating was particularly strong among adolescent girls. Indeed, the use of unhealthy or extreme weight control behaviors and binge eating in this group was "alarmingly" high, Dr. Neumark-Sztainer said at the conference, which was sponsored by the University of New Mexico.

Twenty percent of adolescent gifts were classified as moderately overweight, and 12.6% were very overweight, defined as a body mass index above the 95th percentile for age and gender. Among very overweight girls, 76% engaged in unhealthy weight control practices, including skipping meals, fasting, or smoking more cigarettes.

Moreover, 18% of very overweight gifts engaged in extreme weight control practices: taking laxatives, diuretics, or diet pills, and/or self-induced vomiting.

"This is a group I think slips through the cracks," she said. "We need to address their needs. …