Friday, February 16, 2007

The Extremes of Body Mass Index

Scientists for years been asking the question about why modern Western society has high amounts of people suffering from the extremes of eating disorders; both anorexia and obesity. Much has been made of the effect of overly thin models on young women and the so-called ‘thinspiration’, possibly linking to anorexia. Whatever the answer, the neurological connection between the images and the illness is discussed below:


Anonymous said...

utterly frightening vid, repulsive..I have watched with interest this obsession over the years with catwalk size and it makes no logical sense.Even when various tv progs show interviews with "normal"(??) blokes who profess to not like the catwalk type model and all the other progs that discuss the risk etc,no one seems to take any notice.Only a few days ago, a tv prog on Victoria Beckham showed her efforts over the years and 3 children of attaining this thinness and maintaining it.The final shots of the prog featured her evidently saying that she can now move to Los Angeles where her thinness will be approved of! Utterly fightening! What on earth is the answer to these various eating disorders is completely beyond my comprehension I know that as all the basic logic seems to be overlooked by the sufferers. I realise that is true for many many easy answers is there?

Dr Michelle Tempest said...

Thanks Ceeque for your comment. There is no easy answer, but perhaps us as consumers, have more power than we think. For example, magazines report an increase in sales when Victoria Beckham is on the front cover - if the consumer didn't buy them, I wonder how long it would take before they changed their idea of their favourite cover girl. Michelle

Anonymous said...

What a fantastic site. Thank you, Michelle, for keeping us all informed about this.

Anonymous said...

out of interest i showed this vid to my 19 year old son....."he said it was disgusting and why do girls want to look like that " Thin is definately not beautiful.....

Great blog by the way....

SeaSpray said...

What a powerful and moving video as well as alarming.

If I had known about anorexia or bulemia when I was a teenager, I probably would've fallen into one of those traps. I remember intentionally not eating anything for a few days (had diet pills) but then binged as soon as off the pills.

My PMD gave me diet pills when I was 15 and I was only 20lbs over weight! But no education with it. Wait - yes he did - it was some ridiculously boring 1000 cal a day diet plan. Why do that tho when had the pills??? - said my teenage brain. Back then I remember doing the grapefruit diet, but mostly skipping meals (only to binge eventually) and I even did the beer diet. That one was mine. Basically eat lettuce during the day and then at night go out with friends and drink. I'd always wake up thinner but of course I was just DEHYDRATED! :)

To this day - I never feel better than when I have an empty stomach. Something happens to me psychologically when I eat that seems to slow me down. I KNOW breakfast is important. I KNOW several smaller meals throughout the day is healthier and keeps the body BURNING calories as opposed to it slowing down and conserving the body fat in case of famine. I KNOW exactly what kinds of foods are good for your body. I really could write a book about this. I KNOW! I KNOW! I KNOW! Still, the old tapes persist in playing and old habits die hard.

As you can imagine, I yo-yo'd (WORD?)myself up the scale. I wish I had all the good info that is out there now and maybe, I wouldn't have succumbed to the quick fix.

Conversely, I have a friend who never ever starved herself and she is someone who has to watch her weight, but she keeps herself looking really good. If she skips a meal she feels like she is dying.
When we were teenagers, she always did it right and even before bed she would have to have cereal or a banana - something healthy.

I did all the crazy stuff and i have weight issues - she didn't and she might wrestle with 10 lbs in the winter but it always comes off by summer.

Even now - just coffee. I can go hours without eating and i love breakfast. i am just in a different mode when I wake up. But then having worked 3-11 at a hospital for 20yrs and eating at night is when I really started to gain weight.

I can not tell you how hard it is for me to put that 1st bite of food in my mouth in the morning - even if it is healthy.

What I really believe now - is truly - everything in moderation. I don't do low fat or diet anything. Real food - closest to how God made it. I did lose 50lbs in the last year and 1/2. Also, no eating after dinner unless something healthy like fruit or cereal.

I do have the head knowledge, but it competes with the old tapes every day.

Hmm.. I did not intend to say much but this post struck a chord within.

I like your blog and will be back. i hope it is alright if I link to you.

Have a beautiful day!

Dr Michelle Tempest said...

Daniel, Sally, thanks for the visit and the comments.

Seaspray, thanks for the heart felt words, and the link. I shall certainly check out your blog. Michelle

QUASAR9 said...

Hmmm - Michelle
I don't think the slimming industry profits much from those models - no one fancies being like that.
Maybe what they need is a pair of glasses - rather than a diet plan

Or maybe they should go on holidays to Biafra or Ethiopia & Eritrea if they want to still see what malnutrition looks like when you have no credit cards or supermarkets filled with food.

I would have thought it is easier to get people to eat - smoothies, vegetables, fruit, ...
than it is to get people to stop eating.

Did you know the average person eats three times more than they need, that is why we have an exit hole ... else some would eat till they burst, like the guy in the restaurant at the end of the universe in the hitch-hiker's guide to the galaxy!.

You look pretty healthy to me!

Dr. Deb said...

That Beckham is here in the US will no way make it easier for her to be "thin". And it would be amazing if those who purchase such mags, etc. would stop.

Dr Michelle Tempest said...

Thanks Quasar9 for your comments. These girls are not at risk of the hitch-hikers guide to the galaxy I would agree! There are many many serious side effects to eating disorders. Even when anorexics start eating again they are at risk of re-feeding syndrome. It's a very dangerous illness.

Dr Deborah, thanks for your comment, Victoria B over In the US - watch out...she'll be on the front of magazine near you soon! Michelle

jmb said...

Well that video certainly is a shock to the system. Those images are really extreme, but no doubt the reality for many an anorexic. Which country has the highest incidence? Do you deal with such patients regularly? It must be hearbreaking, and especially for the parents of these young girls.
The post below was very interesting.
I do find it hard to believe that wanting to look like a zero sized model is a strong enough reason to stop eating. But I could see it as an additional influence factor in somone who is already following that path for whatever reason.

Dr Michelle Tempest said...

Dear jmb, Thanks for your comments. Another problem with anorexia is that much of it goes undetected, which is a shame as getting professional help has been shown to significantly increase the chances of survival. Sadly, I have known girls die from the disorder - I am sure most health care professionals have.
Although you say the link between wanting to look like a size zero model is hard to believe, Eric Stice (Arizona State University) did an intersting study, in which he showed that the more TV you watch and the more magazines you read (of whatever variety), the more likely you are to end up suffering from an eating disorder. All interesting stuff! Thanks so much for joining in the debate. Great Westie picture by the way. Michelle

View from the Trekant said...

Had a young woman on our cardiac service who looked like one in your video.

She had a severe cardiomyopathy and was in heart failure. Doesn't matter, she didn't want to eat even if her heart was dying. Profoundly sad.

On a different note, my hubby tossed out our TV in 1992.

I had hoped that would shield my daughter from alot of the unhealthy images of women.

She came home from junior high this year, asking us if it's true that she's "too fat."

Ian Lidster said...

A thoroughly chilling video, and that, combined with your analytical piece below suggests that there are insights that need to be gained in this realm. I think your points in the second piece should definitely be explored more extensively. I am (though no longer practicing) a certified addictions counsellor, and see this as yet another manifestation of addictive behavior, and the link here has to be whatever 'payoff' the anorexic gains from (usually) her behavior. There must, I think, be a pleasure or comfort aspect to this. A pleasure that would be invisible to most of us. Just my thoughts, and thank you again.


Anonymous said...

I had my Body Mass index taken this week...I was not happy at all!..Then I look at this and I should be thankful but I still want to lose.

Dr Michelle Tempest said...

Dear view from trekant - thanks for your comment. Thanks for your comment about cardiomyopathy, it is hoped that through debate and education more people will understand the dangers of anorexia and bulimia.

heidi and ian thanks for your thoughtful comments.


Bob - said...

Hi Doc, I am new to your blog and I am sure this has been discussed already but It amazes me on "why" many women don't have more Self-Confidence!! this video stems from more maybe then that issue BUT i have met so many, amazing powerful women in the business & athletic world but they still have that ISSUE deep inside of them of "are they worthy of success or love or whatever else they get caught up in THiNKING...just tugs at my heart!! YES U AREEE!!!

do u find a lot of women that battle with the self-confidence issue? even when things are going great they tend to dwell on seeds of doubt!

I know I have a lot to learn about women,I do know women are so STRONG they prove it all the time (single professional moms amaze me how much they do) and in the ULTRA running events U always see some women at the top, beating a lot of men...and those events are 80-90% mental!!

well I am rambling a bit but like I said "CONFIDENCE" why do a lot of women question it? and challenge it sooo much, even when things are going well for u have a post on this issue that i can read? or maybe you can post a new one on this topic and get some feedback from fellow bloggers.

Thanks Doc,


Dr Michelle Tempest said...

Thanks for your comments Bob. I shall certainly be blogging more about confidence in the future - but in the interim you may want to check out the post about self-esteem. Thanks again. Michelle

Unknown said...

Truly a chilling video! I hope media is able to educate youngsters, with videos like this and through the print coverage this issue is getting.
Although everyone agrees eating disorders are multifactorial, some argue that being inherently biological, media should not have much influence on the incidence of these disorders. However, we have all seen the incidence of eating disorders rising, which could be because of the fact that we are more aware of these disorders and are diagnosing more or that the external factors have become more influential. I practiced in India as a psychiatrist before moving to the UK. There, eating disorders were virtually unheard of, except for rare patients with anorexia who would come for psychotherapy, certainly not as ill as the ones I have seen here. However, now with more 'westernisation' of the society in India, there has been a definite increase of eating disorders, especially of bulimia nervosa. More and more youngsters have body image disturbance, restrict eating, exercise excessively with the idea that thin is beautiful and thin equals successful. This observation is in keeping with Dr G. Russell’s who initially described bulimia in 1970s after he noticed an increase in bulimic type symptoms in patients who eventually developed anorexia. He mentioned that it was unlikely to be due to a sudden change in gene pool or any infection but probably due to a change in society’s attitude towards body image. The incidence of eating disorders has increased manifold over the last few decades and has now crossed western borders! It’s a shame that organizers of London fashion week and likes do not realize that they are contributing to an emerging pandemic.
I guess, we have to keep doing our bit to raise awareness of these disorders and Dr Tempest, you are definitely doing that through this blog. Keep up the good work!

Dr Michelle Tempest said...

Thanks for the comment Tina - that post offered great insight on a global scale. The idea of a pandemic is indeed chilling! Michelle

MJ said...

Wow! What a thought provoking video. I worry about girls and boys of today's adolescent generation. Don't know if you saw the BBC report out today stating that 8% of 17 to 34 year old women have engaged in vomiting after a meal to stay thin and a third of young women who are a UK size 12 think they are fat. Worrying times.
(Full story at:

Anonymous said...

Your post made me think of the first dietician I saw at the age of 14. Back then I don't remember BMI being an issue.

However, this dietician decreed that I must lose 4lbs per week. I began to get into a cycle of not eating and barely drinking for four days before the weekly appointment to try and reach this goal. After a few months, I began to realise how unhealthy this was and refused to go back.

Now, twelve years on I weigh much, much more than I did back then and I'm in the process of battling with the NHS for a gastric bypass operation.

My opinion is that most teenagers are pretty suggestible (as much as they would say otherwise) and that the slippery slope towards eating disorders could possibly be prevented if the nation's obsession with BMI were abated. For example, if a 14 year old girl works out her BMI and it tells her she is overweight, even though she is not fully grown, what is she going to do? Go on a diet. Therein lies the problem.

Rebecca said...

Hey! I just wanted to say thank-you for using my video as a makes me feel like something little I did can help change alot of views on "thinness" hope all is well! And I apologize for the sick feeling in the stomach that may be caused from watching my video!