Beyond Health

David Salyer

English 1B

Keener

July 31^st 2014

Beyond Health: The Dangerous Effects of Excessive Dieting

Janet was unhappy with her weight; she was overweight, but not excessively. Her response was to turn to the answer in a pill. At first the diet pills appeared to be working; she was looking thinner, and she certainly weighed less, but wasn’t feeling her best. That’s when Janet got some despairing news from her doctor; she was dying, and there was nothing they could do about it. She had fallen victim to a ‘rare but serious side-effect’. The company that manufactured the pills settled out of court for tens of thousands of dollars, but it was too late, and the damage had been done.

Although Janet is not her real name, her story is. She’s the friend of a co-worker and the dangers have never been more apparent. As a nation, we are overweight, but our solutions are apparently not as clear-cut as they should be. More and more people are turning to unsafe dieting practices like diet pills with dangerous side effects, and eating disorders like anorexia or bulimia to stay thin. The problem is that in some cases these practices can lead to medical conditions more dangerous than the ones linked to obesity. Are we going too far to look like the people we see on TV? Is the solution as simple as eating right, or do we need to do more to change what the media is telling us about weight and being thin?

It seems like you can’t escape the next secret weight loss cure. Commercials for diet pills, Jenny Craig, Weight Watchers, Fiber One, and Lean Cuisine barrage the television set at every commercial break. Banner ads that promise to get rid of your stubborn belly fat are off to the side of almost every webpage we visit. You can’t even go out shopping without seeing billboards, and posters of underweight, attractive models in the store windows, while the larger clothes are exiled to specific stores for the euphemistically dubbed ‘plus sizes’, or the ‘big and tall,’ when that’s actually the national average.

The American public is taking drastic measures to attempt to correct their excessive weight. According to the FCC, Americans spent $2.4 Billion in 2013 on weight loss products and services alone. Are we taking the correct measures to get back on track? Just what drastic measures is this nation taking? In a 2006 study for the International Journal of Eating Disorders, they state that;

"... in a study of female college freshmen ... >40% of women who were surveyed were classified as casual dieters. ... approximately 27% reported dieting for weight control and 22% characterized their dieting as always or often. ... In a population of high school and college women, ... many young women reported skipping meals (59%), eating <1,200 calories a day (37%), eliminating fats (30%) and carbohydrates (26.5%) from their diets, and fasting for >24 hr (26%).

... many women also report using over-the-counter pills, herbal remedies, supplements, laxatives, and diuretics to aid dieting efforts. ... Diet aid use is considered to be risky because the safety and efficacy of diet aids are unknown and are not evaluated by the U.S. Food and Drug Administration. Accurate information about diet aids is limited and Internet sites make dubious claims of effectiveness and safety. ... In a more recent study, 7.9% of normal weight adult women reported using nonprescription weight loss products, including dangerous products such as phenylpropanolamine (PPA) and ephedra, indicating a possible increase of diet aids in the U.S. adult population and the introduction of more harmful products." (Celio et al. 492)

In another study from 2005, of 13.857 high school students, they found that "[n]early one-third of the students perceived themselves as being overweight, while 28.7% of students were overweight as measured by ≥ 85th BMI percentile." Although it's not much it proves that our perception of us being overweight is greater than the number of us who truly are. They also found that these high school students were engaging in risky weight loss behaviors. "... 45.6% of students were trying to lose weight in the past 30 days with both healthful and risky practices: 60.0% exercised, 40.7% ate less..." Unfortunately they also found that; "12.3% fasted 24 hours or longer, 6.3% took diet pills, and 4.5% vomited or used laxatives." Surprisingly, with this much attention on trying to shed the pounds, their numbers also showed; "... that 35.9% of students did not exercise vigorously in the past week, 64.2% were not active at least 60 minutes on five or more days in the past week, 37.2% watched TV and 21.1% played video games three or more hours on an average school day, 79.9% did not meet fruits/vegetables consumption requirement (≥ 5 servings/day)..." (Forest 1) All of the subjects surveyed in this study were in high school, and many of them were utilizing drastic, and dangerous measures to slim down. This shows how early the pressure about body image gets to you, as well as the wrong ways to go about it. As many as were using diet pills, 24 hour fasts, and vomiting and laxatives to lose weight, nearly 80% didn't even eat enough fruits and vegetables a day, showing that education about healthy eating practices is also in order.

Both of the studies above was conducted on high school women, so it's clear that the pressure to be thin effects us early on, but why is it that these "normal weight adult women" from this last example in the first study felt the need to use diet pills? To understand that, we need to examine what 'normal' has meant throughout history.

Today, as a society we're obviously more drawn to thinner individuals, but it may be surprising to learn that it hasn't always necessarily been that way. Just like tans were associated with the common laborers working in the sun all day, fat too, once had quite a different interpretation. One of the oldest man-made pieces of art found from the period of early man, (as early as 25,000 years ago, in fact) was that of the Venus of Wilendorf. (pbs.org) It is a very small carving of a very large woman, and they’ve found quite a few of them. At first Anthropologists were confused, but historically speaking, the shift in our desire is quite justified. You don't have to look back that far to see when we thought that heavier-set people were more desirable. In medieval times, for example, just such a thing was true. The people who were starving and unhealthy were much thinner than the heavier-set nobility and royalty, who had sufficient money, and thus sufficient food to eat, along with the fewer health problems that starvation brought. In our time of highly processed, inexpensive foods, however, we pay the higher prices for the organics, and the cheaper products are laced with high fructose corn syrup. (A sugar substitute that's cheaper to manufacture but doesn't digest in your body as efficiently, leaving you with excess fat.) In this age higher weight is now associated with a worse diet, lower income, and more health risks than being thinner. There's been a complete reversal than what was present just half a millennia ago.

According to the UCLA statistics department, on their research of the average BMI (or body mass index; a tool used to determine someone's fitness from their height and weight) of a select list of supermodels and actors, they are all weigh less than the standard population. With an average BMI being 24.63 for females and 25.40 for males, and a healthy BMI range being 18.5 − 24.9, 25.0 − 29.9 being overweight, anything below 18.5 being underweight and anything 30.0 and over being overweight. (cdc.gov) UCLA found that actresses weigh an average of 117.8lbs and an average underweight BMI of 18.02 while the average female weighs 148lbs, and supermodels an average of 118.4lbs with a shocking low BMI of 16.83. Meanwhile male models weigh an average of 180lbs with a BMI of 23.67, while the average man weighs in at 172lbs. (stat.ucla.edu) The BMI's are so much lower than the weights appear to be because of our interest in taller thinner models. (Their height adds to their weight, but the BMI eliminates that variable, showing us just how underweight they truly are.) It's clear to see how much more pressure is placed on women to be thin however. While male models still have a BMI in the healthy range, supermodels are shockingly, and unhealthily thin.

One might wonder, with our movies, our magazines, and our storefronts all featuring these underweight models, what kind of a message are we sending to our youth? The argument of influence on children has been a common one, but just what- if anything is happening to our youth as a result of our media? According to the National Institute of Health, eating disorders, although unlikely until teenage years, can form in children as early as eight years of age. (nimh.nih.gov)

Just what is the big problem with using over-the-counter pills to cut back on your weight? If we examine an excerpt from the American journal of Public Health, we can see just what can arise from abuse of these medications; "Serious health consequences can result from abuse of these OTC products, such as acute and chronic impairment of gastrointestinal and cardiovascular systems, sometimes resulting in death." That's a minor or serious inability of the functionality of your digestive or cardiovascular (heart and lungs) systems, that could possibly kill you. "Adverse effects include dehydration, chronic diarrhea and constipation, metabolic acidosis..." Metabolic acidosis is a condition where the body has too much acid in it, and can lead to comma or death. "...hypokalemia, [(too much Potassium in the blood,)] and other fluid and electrolyte disorders; cardiac arrhythmia[, (irregular heartbeat,)]; hemorrhagic and ischemic stroke; and hepatic and renal failure." (Hepatic is the liver and renal is the kidney.) (Pomeranz et al. 220)

One advertisement springs to mind that appeared on television just the other day. The commercial was for a prescription weight loss medicine named BELVIQ, and the ad makes some interesting claims, including but not limited to; "When used with diet and exercise, BELVIQ can help you lose weight and keep it off." (emphasis added,) along with "BELVIQ works by activating receptors in your brain that are believed to help you feel full. for some people this means that they can eat less." (emphasis added.) The fine print at the bottom of the screen as this was said read, " The exact mechanism of action is not known." The fine print also reads that "BELVIQ is a federally controlled substance with some risk of abuse or dependence." along with " It is not knows if BELVIQ is safe and effective with other weight-loss products or if BELVIQ changes your risk of heart problems, stroke or death due to heart problems or stroke." Those statements don't even begin to compare to the side-effects the announcer told us about. They are, as follows:

"Do not take BELVIQ if you are pregnant, planning to be, or nursing. Before taking BELVIQ, tell your doctor if you take medicines for depression, migraines, mental problems, or a cold, as these medicines with BELVIQ may cause serious or life-threatening side-effects. Call your doctor if you have confusion, sweating, fever, or stiff muscles. Some people taking medicines like BELVIQ have had heart valve problems. Call your doctor if you have trouble breathing, swelling dizziness, fatigue, or irregular heart beat. Don't drive or operate heavy machinery until you know how BELVIQ affects you. High doses may cause mental problems. Talk to your doctor if you become depressed, or have thoughts of suicide. In patients with type-2 diabetes, weight loss may cause low blood sugar. Stop taking BELVIQ and tell your doctor if you have prolonged erections, or if your breasts start to make milk or increase in size. BELVIQ may decrease blood-cell count. Common side-effects include headache, dizziness, fatigue, nausea, dry mouth, constipation, back pain and cough. BELVIQ may help you lose weight and keep it off."

Our desperation for a cure to our obesity is clear when an FDA approves a drug that will make us thin, but this many side-effects.

This over-the-counter medication is just one way that young adults are finding to stay thin. Many people also, either consciously or unconsciously, develop an eating disorder such as bulimia (binge-eating followed by a means of expelling the recently consumed food to keep your weight down, including but not limited to vomiting,) or Anorexia (having a mental self-image that you're actually much heavier than you are. Drastic dieting techniques are employed to keep one's weight 'down'.) (nimh.nih.gov) According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), up to 24 million people suffer from eating Disorders in the United States alone. What's more, 50% of people who suffer from bulimia nervosa develop it by the age of 18. (Pomeranz et al. 220)

Whenever you hear about some actor’s incredible transformation, the secret always seems to be the same; “Diet and exercise.” So why is it that we’re still looking for the next miracle cure? Whether it be the cure in a gelatin capsule, or in somehow cheating the system to trick your body into thinking you've eaten- it seems like we don't want to face the hard work of what we know to work. Beyond that however, we need positive body image promotion in the media. As Marshall McLuhan said, "The medium is the message." (Jacobus 825) Postman helps to explain in his book by discussing "...the power of television to influence children by inundating them with adult content that emphasizes consumerism, materialism, and adult hedonism." (Jacobus 826) Certainly if television can be that influential, children will pick up on subtle stereotypes and stigmas towards a certain group of people.

One a huge problem is the complete lack of a depiction of overweight people on television and print. Considering that 68.5% or all Americans are overweight or obese (frac.org) there's a huge portion of the representative population suspiciously absent. "... only 25 percent of men on television were overweight or obese, compared to almost 60 percent of American men. ... Almost 90 percent of women on TV were at or below normal weight, compared to only 50 percent of American women." (Whyte 321) Even more disparaging however, is the depiction of overweight individuals when they are present in the media. Overweight actors are typically played off as the comic-relief. "Popular television shows that include people who are obese portray them either as comedic, lonely characters, or freaks." (Whyte 321) "Movies like The Nutty Professor, Norbit and Shallow Hal, where actors dress up in fat suits and engage in clichéd slapstick (like getting stuck in small spaces because of their girth), have earned millions of dollars at the box office by mocking the obese. This phenomenon even earned the unwelcome label – “fattertainment” – media that is both immensely popular and a breeding ground for obesity stereotypes." (Heuer) You don't see an obese actor as the lead in a romance unless it's a comedy. "Obese characters are shown overindulging in junk food and are less likely than thinner characters to be involved in romantic relationships. 'Fat Monica' on the hit show Friends is a prime example. When Monica is thin, she’s portrayed as attractive and lovable. But, when dressed in a fat suit, 'Fat Monica' is portrayed as pathetic and not able to stop eating." (Heuer) We don't have very many positive heavy-set role models for our youth. "There are many successful people who are overweight and obese in today’s society, but that is not reflected in popular entertainment." (Whyte 322) Maybe that could have been the end of it, but the problem is that these negative stereotypes towards the overweight don't just stay on television. Much like any negative stereotypes, they become engrained in the viewership. "Negative stereotypes are attached to obese individuals, who are often thought to be undisciplined, dishonest, sloppy, ugly, socially unattractive, sexually unskilled, and less likely to do productive work, among other attributes." (Greenberg et al. 1342)

If we hope to improve our overall health as a nation, we need to start with the images we are feeding our public. As a nation, we could eat healthier, but we need to start promoting a positive body image. It’s unhealthy to be as thin as most supermodels, and dieting pills and eating disorders are certainly not the solution. We need to start by changing what it being told to the unconscious minds of millions of viewers. Changing our processed convenience foods would be good too, but we need to start at the source and change people's perspectives about the obese if we hope to change anything.

Annotated Bibliography

Postman, Neil "The Word Weavers/The World Makers" A World of Ideas: Essential Readings for College Writers. Ed. Lee A. Jacobus. 9th ed. Boston: Bedford/St. Martin's, 2013. 829- 839. Print.

Jacobus, Lee, A. "Neil Postman" A World of Ideas: Essential Readings for College Writers. Ed. Lee A. Jacobus. 9th ed. Boston: Bedford/St. Martin's, 2013. 825-828. Print.

Food Research and Action Center. N.p., n.d. Web. 29 July 2014. <www.frac.org>.

UCLA Department of Statistics. N.p., n.d. Web. 29 July 2014. <www.stat.ucla.edu>.

Centers for Disease Control and Prevention. N.p., n.d. Web. 29 July 2014. <www.cdc.gov>.

National Association of Anorexia Nervosa and Associated Disorders. N.p., n.d. Web. 29 July 2014. <www.anad.org>.

Federal Communications Commission. N.p., n.d. Web. 29 July 2014. <www.fcc.gov>.

National Institute of Mental Health: National Institutes of Health. N.p., n.d. Web. 29 July 2014. </www.nimh.nih.gov>.

Public Broadcasting Service. N.p., n.d. Web. 29 July 2014. </www.pbs.org>.

Heuer, Chelsea A., MPH ""Fattertainment" - Obesity in the Media." Obesity Action Coalition. N.p., n.d. Web. 30 July 2014. <obesityaction.org>.

Celio, Christine I., MA, Kristine H. Luce, PhD, Susan W. Bryson, MS, Andrew J. Winzelberg, PhD, Darby Cunning, MA, Roxanne Rockwell, BA, Angela A. Celio Doyle, PhD, Denise E. Wilfley, PhD, and C. Barr Taylor, MD. "Use of Diet Pills and Other Dieting Aids in a College Population with High Weight and Shape Concerns." International Journal of Eating Disorders 39.6 (2006): 492. Chaffey College. Academic Search Complete. Web. 14 July 2014.

Pomeranz, Jennifer L., JD, MPH, Lisa M. Taylor, JD, and S. Bryn Austin, ScD. "Over-the- Counter and Out-of-Control: Legal Strategies to Protect Youths From Abusing Products for Weight Control." American Journal of Public Health 103.2 (2013): 220. Chaffey College. Academic Search Complete. Web. 14 July 2014.

Forest, Kimberly Y.Z., PhD, and Alyssa G. Forest, B.S. "Correlates of Risky Weight-Control Behaviors in Adolescents." American Journal of Health Studies 23.1 (2008): 2-3. Chaffey College. Academic Search Complete. Web. 14 July 2014.

Greenberg, Bradley S., PhD, Matthew Eastin, PhD, Linda Hofschire, PhD, Ken Lachlan, MA, and Kelly Brownell, PhD. "Portrayals of Overweight and Obese Individuals on Commercial Television." American Journal of Public Health 93.8 (2003): 1342. Web. 30 July 2014.

Whyte, John, MD, MPH. "Media Portrayal of People Who are Obese." American Medical Association Journal of Ethics 12.4 (2010): 321-322. Web. 30 July 2014.