Eating Mindfully

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The Epidemic

What is really eating our country

I want to call your attention to two recent research studies in hopes that they may shed some light on our current “obesity epidemic”.

In the study “Does obesity associate with mortality among Hispanic persons? Results from the national health interview survey,” by Mehta et al (2013) published in the academic journal Obesity, the authors studied over 40,000 Hispanic adults living in the United States and concluded that overweight and obesity were not associated with increased mortality (death). This study replicates results of an earlier study by some of the same authors. That study, titled “Body mass index and mortality rate among Hispanic adults: a pooled analysis of multiple epidemiologic data sets” by Fontaine et al (2012) was published in International Journal of Obesity and not only found that there was no association between overweight/obesity and increased mortality rate for the over 16,000 Hispanic Americans in their sample, but that overweight and obesity was actually associated with reduced mortality for adults over the age of 60 years old.  The authors pose the following as an explanation for their results: “culturally-driven differences in body image and body attitude may compel fewer Hispanic adults to attempt weight loss, which raises the possibility that the absence of repeated bouts of weight loss and regain (i.e., weight cycling) may contribute to a reduction in the association of BMI to mortality rate observed in this population.” Essentially, the authors believe that it may be dieting that is responsible for the health problems often attributed to obesity. This is yet another in a series of studies that consistently finds that being overweight or obese is not associated with increased risk of death. With the exception of being underweight (which is associated with increased mortality), Body Mass Index (BMI) does not prove to be an accurate predictor of health and life expectancy.

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I think that this study is particularly interesting when considered in context of another study published last week in Pediatrics. In “Eating disorders in adolescents with a history of obesity” (Sim, Lebow, & Billings; 2013), a group of doctors from the Mayo Clinic wrote about something that overweight and obese people are actually at risk for: eating disorders. The authors write: “patients with a weight history in the overweight or obese range represent a substantial portion of patients presenting for ED (eating disorder) treatment.” In addition, it takes significantly longer for these patients to be diagnosed with an eating disorder than patients without a history of overweight or obesity. This delay in diagnosis and treatment results in psychological and physical health consequences. The study revealed, that despite clear eating disordered behaviors and presentation to medical doctors with eating disorder related symptoms, these adolescents were not diagnosed and referred to treatment but were more often encouraged to keep up the "good work" with weight loss and to continue engaging in the eating disordered behaviors. Basically, the doctors were so pleased that the patients were losing weight they didn’t pay enough attention to how they were doing it or the health consequences of the weight loss. This is not uncommon when we narrowly focus on weight loss.

It is studies like these that make me wonder, what kind of epidemic do we really have in our country? Is obesity the problem or is our focus on obesity the problem? If more and more research concludes that what and how we eat is more important for health than what we weigh, then why do we as a society continue to focus on weight?

It is unfortunate that these studies didn’t get more media attention. What does get media attention? Turn on the television or pick up a magazine and it is hard not to see features on the newest weight loss tool, diet pills, or exercise plan. News anchors converge to scrutinize celebrities’ bodies and we continue to hear about the “obesity epidemic” on the evening news.  It seems to all fits together nicely; the problem is fat and the solution is weight loss. Unfortunately, it doesn’t work. The reality is, the problem is disordered eating and the solution that is posed (weight loss) only leads to intensification of the problem. People can be healthy at a diverse range of shapes and sizes. It is unfortunate that we fund research studies only to have the results buried in academic journals, while the media continues to promote the same old message. I, for one, would have welcomed a break from last month's urgent news coverage of Miley Cyrus’ twerking episode. 

To learn more about mindful eating and Dr. Conason's practice, please visit her website at www.drconason.com

Alexis Conason, Psy.D. is a clinical psychologist in practice in New York City and a researcher at the New York Obesity Nutrition Research Center at St. Luke's-Roosevelt Hospital.

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