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Are Body Dissatisfaction and Disordered Eating Key Drivers of Obesities?

Yesterday, at the International School on Obesity Research and Management currently underway at Lake Louise, Alberta, several presenters (Shelley Russell-Mayhew, U Calgary and Claudia Sikorski, U Leipzig) focussed on the role of negative body-image and the stigma of obesities on weight gain in both men and women.

This topic is of substantial interest in light of the growing evidence that obesities often begin with poor self-esteem and negative body-image which may perpetuate overeating.

This issue was further examined by Christie Urquhart and Tanis Mihalynuk from Acadia University, Wolfville, Nova Scotia, in a paper just published in the Canadian Journal of Dietary Practice and Research.

As the authors note:

“Contemporary Western society emphasizes thinness for women, and the ideal female body size has become progressively smaller over the past half century. Meanwhile, the actual female body size has increased steadily, and rates of aberrant attitudes and behaviours surrounding food and weight have risen and tend to be much more common in overweight individuals. Thus disordered eating and excess body weight may perpetuate each other’s development.”

In their paper, the researchers synthesise the literature on female body size and disordered eating with regard to eight common cognitions and behaviours that occur in women:

  • media exposure
  • weight stereotypes
  • body dissatisfaction
  • dieting
  • “fat talk”
  • emotional eating
  • perfectionism
  • the “superwoman” ideal

Based on their analysis of the literature, it appears that all of these factors may play a role both in disordered eating and obesities.

In addition, their findings suggest that these factors may induce triggers, exacerbated by perfectionism and excess weight, that increase the risk of binge eating. These triggers include interpersonal discrepancies, low interpersonal esteem, depressive affect, and dietary restraint.

These findings clearly emphasise the potential importance of interventions targeting the negative cognitions and behaviours in addressing both disordered eating and obesities among females.

As noted before, it appears that when it comes to the relationship between unhealthy eating behaviours and obesities, it may be far more important to address the “why” than the “what”.

Obviously, these findings also support the notion that policies equating “health” with “weight” together with the societal obsessions with thinness and weight loss may well be root causes of the obesities epidemic.

This may certainly prove an important conundrum for public health campaigns focussing on reducing weight to improve population health.

Lake Louise, Alberta
Urquhart CS, & Mihalynuk TV (2011). Disordered eating in women: implications for the obesity pandemic. Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada, 72 (1) PMID: 21382233


  1. I might have to read more about this to wrap my head around it. I’ve always thought that I felt bad about myself because of my size. Its definately possible that its the other way around however. I really cannot remember which came first. I was quite young when both the shame and the weight problem started.

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  2. Oh man. This kind of “you’re fat because you have emotional problems” thing is so old and of such limited use. Sometimes a fat person is just a fat person; a natural result of human variation. I’m sure this sort of thing does play a role in some cases, but I’ll bet that 75%+ of weight variation is based in heredity and physiology.

    This is how I think it works, although I don’t know the mechanisms. Fat is like a savings account. Some of us start out with bodies that are risk averse and like to keep large emergency funds. However, the more we starve (either because of dieting or real food shortages), the more cautious our bodies become; the more fat they want to store. That’s why dieting causes long term weight gain.

    Telling fat people that they’re mentally ill is just as bad as telling them that they’re weak and greedy.

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  3. I agree with this article – it’s very much how I work. A lot of people’s lives are being totally ruined through striving for an ideal that is not achievable and then suffering the sense of failure from not achieving it. This leads to years of diet cycling and reduction in body confidence and self esteem.

    I help my clients to stop dieting, begin to appreciate and value thir bodies, and build self esteem and confidence (similar to HAES). Depending on the many, many complex factors involved in fat gain and loss, some stabilise, some lose a lot of fat and some lose a bit of fat. All definitely get fitter and happier.

    While obesity has risen suggesting that there is more at play than simple hereditary factors, the obsession with thinness and body image have created a huge weight of fear and anxiety that has led to mass dieting followed by dieting failure. You end up with weight gain associated with that (as highlighted by Brownell etc).

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  4. This is very interesting. While I agree with DeeLeigh, that human body weight follows a bell curve, and always has, the curve has moved in recent decades, and this movement does coincide with a burgeoning diet industry that preys on women’s psyches. Is this the egg that hatched the chicken? Or, more precisely, one or two of several chickens (I appreciate the use of obesities plural, as you might guess). It’s easy for me to see how all the media attention (commercial programs and general obsession running in the articles of most women’s magazines) may have resulted in an increase in body dissatisfaction, “fat talk,” weight stereotypes (the diet industry would go bankrupt if we stopped believing in the absolute truth of ELMM — “and use X product to help you EL while you MM”), and all of that, particularly the dieting and yoyo weight cycling, could increase our average weight.

    This is when I get so frustrated with not being able to get through to whole articles. I would love to know what they meant by “interpersonal discrepancies.” Is that referring to economic discrepancies or is it “thin privilege” or is it the mental game of sizing up and comparing: “Hmmmm, looks like I’m the third fattest woman at this pot luck dinner, maybe even fourth by the looks of that woman over by the coffee urn.”

    In addition to the center of the human body weight bell curve moving ever further right, I understand it has morphed and flattened, as more people have become very, very fat — superobese is a term that’s used, I believe? — people incapacitated and housebound by their fat. If I were to speculate, I think that the phenomenon you describe here, the subject of Urquhart and Mihalynuk’s paper, may have had a big influence on the movement at the center of the bell curve. With regard to the right end morphing, some other modern factors are likely at play, such as one or more endocrine disruptors (livestock hormones? birth control showing up in water supply?) or other obesegens (anti bacterials that kill beneficial gut flora, pesticides, food additives, etc.) or epigenetics.

    I hope your experiment with the plural proves successful. It is, indeed, truthful. Are people ready for it? Hmmm. Hope it felt good falling from your fingertips.

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  5. I tend to think of it as being stuck in quick sand, the more you fight it and the more frantic you get the further down you sink, then you have friends, family, obesity researchers smuggly standing on the bank telling you “just pull youself out by your bootstraps! (just eat less and exercise more!)”. Fact is pulling yourself up by your bootstraps doesn’t even make sense, you have nothing to push against, same goes for trying to “fight” your own metabolic feedback loops by yourself, it’s just like trying to pull yourself out of quicksand by your bootstraps, it makes no sense.

    What needs to be done is to quit the blame game and come up with creative solutions that actually make sense.

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