Briefing promotes incorporating eating disorders into obesity legislation

Legislators and school officials may inadvertently promote eating disorders as many states look to pass obesity-fighting legislation that, for example, requires a child's body mass index be included on a weigh-in report card to parents.

Speakers pointed to the problem at a June congressional briefing, "Schools, students, obesity and eating disorders," coordinated by the Eating Disorders Coalition for Research, Policy and Action (EDC) and sponsored by Sen. Hillary Rodham Clinton (D-N.Y.). Psychologist and EDC founder Jeanine Cogan, PhD, was among those who spoke at the briefing, which pushed for legislation that acknowledges the overlap between obesity and eating disorders. The briefing coincided with Eating Disorders Advocacy Week, in which EDC members lobbied Congress for greater congressional, school and community support of eating disorders.

"Unfortunately, our approach to childhood obesity is doing harm and has been making the problem of eating disorders worse," said psychologist Margo Maine, PhD, who has specialized in treatment of eating disorders for more than 20 years. For example, states--such as Pennsylvania and Arkansas--have approved mandatory school weigh-ins of children, which Maine said may cause children to become dissatisfied with their bodies and, ultimately, lead to dangerous dieting behaviors.

Maine pointed to research that indicates a high prevalence of obesity and unhealthy weight-control behaviors among adolescents. In fact, more than half of 12th grade girls and 31 percent of 12th grade boys report having used dangerous dieting methods, such as fasting, purging or diet pills, Maine said.

In particular, Clinton and EDC officials highlighted the proposed Improved Nutrition and Physical Activity Act (commonly known as the IMPACT Act). The bill would provide grants for training health professionals, increasing physical activity and promoting healthy eating aimed at preventing obesity, excessive weight or eating disorders--particularly among youth. IMPACT received Senate approval last year but died in the House. Senate Majority Leader Bill Frist (R-Tenn.) reintroduced the bill with a bipartisan coalition of 25 other co-sponsors, including Clinton.

"This briefing is a very important piece of the ongoing effort to advance federal recognition of eating disorders as a public health priority," Clinton told the audience. "Obesity should always be talked about in the same sentence as eating disorders."

Cogan agreed. "We hope it sets a precedent for any future obesity bill ever introduced" in acknowledging obesity and eating disorders in the same legislation, said Cogan.

Any attempt to promote healthy lifestyles and prevent eating disorders must be comprehensive, Clinton said. "It has to include education about nutrition and physical activity, and it must encourage open communication about body image and self-esteem," she said.

For example, S. Bryn Austin, ScD, an assistant professor at the Harvard School of Public Health, presented her research on the Planet Health Intervention--outlined at www.hsph.harvard.edu/prc--which promotes an interdisciplinary curriculum through classroom and physical education activities to improve healthy eating, increase physical activity and reduce TV viewing.

Girls 10 to 14 years old who underwent the intervention were less than half as likely to report purging or using diet pills than girls who did not go through the program, according to a study in the Archives of Pediatrics and Adolescent Medicine (Vol. 159, No. 3, pages 225-230).

EDC officials and Clinton also expressed support for the Paul Wellstone Mental Health Equitable Treatment Act, which would prevent large health plans from imposing limitations on mental health treatment--including for eating disorders--that differ from those placed on medical benefits.

--M. DITTMANN