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The War on Obesity: Collateral Damage in Eating Disorder Patients

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It's January; an exciting time for the serial dieter. Magazines are pushing their '101 ways to detox' at us whilst exercise DVDs by C-list celebrities get even cheaper in the sales. Luckily for the diet industry, the dawn of 2013 saw another large serving of fiery reports about the UK's obesity crisis dished up in the press. You can just picture all the diet warriors dashing out in little green hard hats ready to wage war on overweight individuals.

The obesity epidemic has led to the development of various government campaigns across the UK seeking to promote healthier eating and exercise habits. Change 4 Life and other such campaigns have become high profile and many are familiar with their ideas on smaller portions and more exercise. However, whilst nobody can deny that these campaigns are intended to benefit the health of British people, some have argued that the constant reminders about the negative effects of being overweight is leading to a nation gripped by 'fat phobia'. Dieting has become a socially expected occupation for most people now, with women feeling particularly targeted.
But there is one group of people for whom these campaigns can only spell bad news; those suffering from eating disorders.

When you are ill with an eating disorder you often find as many ways as you can to justify your behaviours to yourself. You convince yourself: 'I'm just being healthy. Being overweight is bad for you so I must starve to avoid it happening to me'. Of course, this justification becomes much easier when you are exposed to messages telling you how fat the nation is and how we're all going to die young from obesity-related consequences. Scary statistics are printed on the front of newspapers and billboards everywhere; alongside them come guidelines on how many calories we should eat and how much exercise we must do. These guidelines and the press coverage of how obese the nation is make thrilling reading for an anorexic or bulimic patient. Firstly it confirms their distorted view of themselves; yes they really are just fat and lazy because the media has just told them so. Secondly, the association made between being overweight and suffering horrible health consequences further adds to their intense fear of becoming fat.

The notion that anti-obesity campaigns provide a source of 'justification' for eating disordered related behaviours isn't a new one; in 2008 researchers (Burns and Gavey, 2008) found that amongst their sample of bulimic women, several concluded that their purging behaviours were 'healthy' as they provided a means of weight management and remaining slim. In a society which condemns us for being overweight we have come to equate 'healthy' with weight loss behaviours and dieting even when this means resorting to disordered habits.

Obesity is unfortunately a big threat to us and is associated with many scary consequences. When the major supermarkets such as Tesco and Sainsbury's agreed to start putting food labels with calories, fat, sugar and salt content on the front of every product they were applauded for taking such a strong stance in this 'war' on obesity. For many individuals this labelling system probably had the desired effect and positively impacted their diets. However, for me, the readily available information just helped catalyse my anorexic behaviours as I strived to consume fewer and fewer calories every day. I spent hours walking round the supermarket every morning examining food labels, working out the lowest- calorie versions of the food items I was allowed to eat. These food labels had me mesmerized and helped me keep on track with starving myself.

Recovery from an eating disorder such as anorexia or bulimia often involves behaviours which conflict with anti-obesity campaigns. Recovery may involve weight gain and the consumption of foods deemed 'unhealthy' to eliminate food-related concerns. Eating a high energy diet is an intense struggle for a sufferer as it is, but when you add in the guilt we are taught to associate with weight gain it can feel near enough impossible. Many treatment clinics ask patients to consume foods like chocolate and pizza as a way of challenging their cognitive assumptions about food. However, when they have been repeatedly faced with orders in the outside world to avoid these foods the task becomes much more intimidating and scary than need be.

Obesity campaigns have their place; our nation needs to stay healthy. Encouraging people to eat more fruit and walk more is definitely a good thing and healthy guidelines cannot be eliminated entirely. But we need to draw attention to the fact that they can be detrimental sometimes and question why the health consequences of being underweight are always omitted from reports, when it can be just as dangerous to be too thin as it is to be too fat.