Break the tyranny of thinness

A former college classmate of mine says she's lost 1,000 pounds in her life, but still weighs the same. The problem is, she regains every pound she loses.

This woman constantly is embarking upon some new fad- like the rotation diet, the one meal-a-day diet or the liquid diet.

Looking in the mirror fills her with shame and guilt ─ and drives her to stop eating. It's a desperate, endless cycle, and she never sees anything but imperfection.

This is what I call tyranny of thinness obsession. Feeling remorse about something as harmless as a late-night pizza break or only nibbling a holiday meal. Cruelly criticizing each imagined flaw in the mirror. Buying clothes a size too small. Never really feeling good about oneself.

The tyranny of thinness obsession is mainly a problem for women, created at least in part by the socialization of girls and women to be beautiful above all else.

Studies show that about half of American women believe they need to lose weight. Often these feelings develop early ─ when we're still carrying lunch boxes to school ─ and continue for a lifetime.

I'm not only talking about the 3 to 4 percent of women who develop serious eating disorders, but a much larger group: those women who constantly feel guilt and even shame about their appearance to the point of chronic dieting. These are the women who slip through the cracks of studies and surveys, the statistically invisible millions living in denial─ severely neglecting their health needs while harboring unrealistic expectations of their bodies.

The consequences of continuous dieting can be unhealthful. By neglecting nutritional needs such as calcium and iron, obsessive dieters increase their risk for problems such as osteoporosis and anemia later in life.

Continuous dieting is also associated with dangerous and severe eating disorders. Anorexia nervosa, a refusal to eat leading to extreme weight loss, can cause yellowing skin, dehydration, excess body hair, gastrointestinal problems, irreversible osteoporosis ─ and it can be fatal.

Bulimia, a cycle of binge eating and purging through vomiting, using laxatives, or exercising excessively, can damage teeth and cause stomach lesions or tears in the esophagus. Those who use drugs to induce vomiting or frequent bowel movements can eventually suffer heart failure or permanent damage to their intestines.

Fortunately, as public awareness increases, more people with bulimia and anorexia nervosa are seeking help from health care professionals. Research shows that early treatment improves one's chances of recovery ─ but it is essential to get professional treatment.

The tyranny of thinnes obsession is something that all of us can work together to prevent, especially on our college campuses. We have to shift the focus from thinness to health, from the loneliness of helpless binges to the joys of healthful eating, hanging out with friends, and doing well on exams.

That means that if you see a friend eating only celery and carrots for the second dinner in a row, ask her,"Isn't there another way?" It means that if you are having a problem, seek help for yourself. It means refusing to allow cultural stereotypes about women's bodies to remain unchallenged.

The roots of thinness obsession and eating disorders grow in the soil of powerful media messages to women that we must be beautiful above all, and that large women are unfeminine. Fortunately, women are learning to reject these false messages and striving instead to be healthy, strong, outspoken and competent.

It's a lot more healthful to play intramural soccer, take long walks, or become a Big Sister than to waste time worrying about the scale. Women need to feel powerful because of our minds, our health, our leadership and our ability to be happy.

Being thin and being healthy are not necessarily the same thing. We all must realize this, and free ourselves from starvation diets and lonely binges.

Donna E. Shalala is the Secretary of the U.S. Department of Health and Human Services. Her address is 200 Independence Ave., SW, Rm. 615F, Washington DC 20201.

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