There is, of course, some truth in amongst the hyperbolic burbling; if you can’t see your toes, it’s probably not good, and if your daily bread is accompanied with seven rashers of bacon and an egg or three, then you’re going to live to regret it. Or not, as the case may be. And with anywhere between two thirds and three quarters of adults in the UK classed as obese depending on whose supersized statistics you swallow, something certainly needs to be done.

 

But what? The current tactic seems to be to focus on the negative effects of being extremely overweight: increased risk of type 2 diabetes, increased risk of heart disease, increased risk of arthritis etc. Not only this, but near-constant cookery and food programmes, as well as just about every magazine ever, tell us what not to eat if we don’t want to be fat and lonely.

 

Until recently, I’d thought that the only impact the relentless anti-obesity drive had on self-esteem was on the people it was directed at: the vast numbers of vast people. But then I was sent a link to a petition on the government website by a friend. The petition was to ask the government to balance the information they gave about obesity with information about other eating disorders, such as anorexia and bulimia, something which many believe could help prevent or limit the damage done by such disorders. Susan Ringwood, chief executive of beat, the leading eating disorders charity in the UK (who were not involved with the petition), told me: “There is anecdotal evidence that some public health messages can make people who may have a difficult relationship with eating or exercise worse. Government agencies have got to treat this area sensitively.”

 

 

The common conception about such eating disorders is that they’re provoked by low self-esteem and poor body image, which is usually squarely blamed on the media and fashion industry. Rows about size zero models and unrealistic advertising regularly engulf the nation’s opinion pages, with the consensus being that if only they’d include some slightly less skinny people then these problems would go away.

 

That’s simplistic cause-and-effect reasoning, but there’s almost certainly at least a little truth behind it. The problem is that this is now the accepted ‘cause’ of anorexia and bulimia for many people, so any other possible factors that could have an effect are largely ignored. This is particularly dangerous for young people in the UK, who are most vulnerable. I asked Rachel, a British student who has anorexia, about the effect the anti-obesity culture has had on her condition.

 

“Encouraging weight loss is the main problem for me,” she said. “You get constantly bombarded with emails, adverts on Facebook, dieting products in shops – you can’t get away from ways to help to lose weight.”

 

“You see the adverts more often than you see the size zero models, and it’s easier to dissociate yourself from the models, whereas you can’t from the adverts. Everyone seems obsessed with losing weight, so you feel you should be too, and if you’re not you feel fat and lazy.”

 

Christine, who is also a student, agrees that the media can have an effect: “It probably doesn’t play a role in the development of eating disorders, but it can help to maintain them. When I was in treatment and on intensive weight gain, so much of the media I saw was saying the exact opposite of what the doctors were saying to me, and that made it more difficult.”

 

Rosie, a third student, agrees with Christine: “The images of super skinny models and celebrities definitely didn't cause my eating disorder, but they did give me something to fixate on once it had developed.”

 

Ali is another student, and has recovered from severe anorexia. She thinks that although the media does have an obsession with how to lose weight, it’s not the whole story: “The media tend to mix their messages. One magazine will tell you at the start how terribly ill and skinny a 'stressed out' celeb is, and a couple of pages on you'll get advice on how to lose a stone in a week!”

 

Magazines, of course, are able to use the questionable excuse that their demographic is adults who can supposedly make informed decisions about weight loss and eating, but adverts on websites like Facebook or Hotmail that are regularly used by younger people can’t even hide behind this. They might not be explicitly directed at teenagers, but there’s little doubt that they’re still seen and taken in by the most vulnerable groups. These adverts don’t discriminate in their targets – I regularly get suggestions for dating agencies on Facebook despite my ‘in a relationship’ status – and so anyone, regardless of their weight, health, or mental condition, is offered ways to lose weight.

 

And it’s not just magazines and adverts; low-fat, healthy ranges in supermarkets and the new information on some restaurant menus in the UK are also contributing to the problem. With the increasingly detailed labels on food it’s now easier than ever to count the calories you consume, and the internet makes it possible to discover the number of calories in just about anything. I’m grudgingly impressed when Rachel lists off the top of her head the number of calories in an array of fruit and veg, but it also makes me realise just what effect the masses of information available can have on someone who already worries about their weight.

 

 

Rachel agrees that the current obsession with ‘healthy eating’ makes it easier for her to convince herself that she should be very, very careful about what she eats: “The focus is really on losing weight. No-one caters for people who want to put on weight, or maintain their weight. I know how I think is irrational, but it’s reinforced constantly.”

 

It’s easy to lay the blame at the door of 10 Downing Street, but Rosie points out that on the NHS website one of the first links associated with diets is about eating disorders. So could the media still have a part to play?

 

Rachel thinks so, but blames the regular stories and images of morbidly obese people rather than the oft-mentioned size zero models: “You hear so much about so many people being overweight, and the average size for a woman in the UK is now 14. But even if you’re not close to that, you feel like if you eat ‘bad things’ you’ll become obese because everyone else seems to have so easily. It’s much easier to be in denial as well, because in your head everyone becomes obese and you’re just a normal size, even if you’re actually underweight.”

 

This is echoed by Christine, who says that when she was anorexic losing weight became almost a source of pride: “Because so many people are overweight, it feels like everyone should lose weight. It was kind of an achievement to lose more weight than anyone.”

 

With so much pressure being put on people to be thin, from government campaigns to adverts in glossy magazines to the labelling on supermarket shelves, it seems logical that for some people it would have a negative effect. But as obesity is so close to the surface of our consciousness, other less publicised eating disorders are often ignored, says Christine:

 

“They have addressed one problem and ignored another major one. They need to consider the people who have eating disorders or who are vulnerable. A lot of the issues surrounding over- and under-eating are to do with self-esteem, and there’s more overlap than people think, but they’re addressed separately.”

 

Dr David Haslam, Chair of the National Obesity Forum, agrees that there is overlap between the disorders, but rejects the claim that obesity is distracting from other eating disorders: “The root cause of both obesity and anorexia is similar: a disordered eating pattern and lifestyle.”

 

“The anti-obesity drive may in fact be adding more focus to the debate on other eating disorders.”

 

 

Either way, it seems anorexia is not being addressed as obviously as obesity, and the help available is not as readily accessible. Ali argues that it’s not taken seriously enough: “It’s sheer neglect that people have to be critically ill, practically on death’s door, before they can qualify for the right to get the nearest inpatient treatment - which can be miles away!” Hardly ideal if you’re a student already struggling with lectures, assignments, and revision, then.

 

Anorexia doesn’t get enough coverage in the media either, says Rosie. “The only time anorexia or bulimia are made a fuss of is when someone dies. Then there’s an article about how awful it was, then it’s over again for a few months.”

 

Instead, she says, obesity generates lots of coverage because “the tabloids can focus on how much it’s costing the NHS.” But even when the media does try to publicise anorexia and bulimia, they get it wrong.

 

“The publicity of eating disorders has become extremely sensationalist,” she argues. “TV shows like Super Skinny Me and Supersize vs Superskinny just point out the obvious and don’t concentrate on why people get eating disorders – they just talk about the after-effects. They give you tips on how to give yourself an eating disorder.”

 

So how can the government – and the media and advertisers – get it right between discouraging obesity and not encouraging other eating disorders? For Rachel, it needs a shift in perspective: “The campaign should be to encourage healthy eating, including eating enough, rather than to encourage weight loss, because that’s not right for everyone.”

 

Ali agrees: “What we need to focus on is how to attain a healthy body weight, and a healthy attitude towards food, rather than how to do the impossible and manipulate your body with food and exercise. It is too much of a dangerous game to play.”

 

It’s hard to argue with that. It remains to be seen whether this or successive governments will pay attention to this aspect of the anti-obesity drive, but the message is clear: if the campaign remains simply ‘lose weight’, then they risk endangering or worsening the mental and physical health of thousands of people.

 

 

April 2009

 

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